Modeling hospital discharge policies for patients with pneumonia-related sepsis

Sepsis, the tenth-leading cause of death in the United States, accounts for more than $16.7 billion in annual health care costs. A significant factor in these costs is hospital length of stay. The lack of standardized hospital discharge policies and an inadequate understanding of sepsis progression have resulted in unnecessarily long hospital lengths of stay. In this paper, a general model of when to discharge a patient with pneumonia-related sepsis from the hospital is presented. The model is parameterized using patient-based disease progression data from a large clinical study in order to characterize optimal discharge policies for various problem instances. In the presented experiments, patient health is represented by Sepsis-related Organ Failure Assessment (SOFA) scores, which are commonly used to assess sepsis severity. Control-limit policies for specific patient cohorts defined by age and race are demonstrated.