A systematic review of the cost-impact of sepsis care bundles.

Abstract

The use of evidence-based sepsis bundles to minimise variation in clinical management of sepsis, improve health outcomes, and associated costs, is well supported in current literature, particularly within high-acuity acute care settings. However, there is limited research evaluating sepsis bundle implementation in subacute, residential aged care facilities (RACF) and broader acute care environments. The aim of this systematic review was to evaluate studies reporting financial outcomes associated with use/implementation of sepsis care bundles across acute and subacute healthcare organisations, and RACF. Electronic searches of the Cochrane database, as well as CINAHL Complete and MEDLINE Complete (via the EBSCOHost platform) were conducted between January 2000 to July 2025. Studies were screened and evaluated by two independent researchers. Twelve studies were identified for inclusion, of these 58.33% (n = 7) utilised an established economic evaluation methodology and five studies (41.67%) outlined the cost impact of sepsis bundle implementation. Results highlighted heterogeneity in reported cost outcomes, sepsis definitions, with limited patient level data and evaluation. Despite heterogeneity of findings, the results of this review indicate clinical and economic effectiveness associated with sepsis bundle implementation in the acute care setting. Sepsis bundle implementation was associated with decreased hospital and/or patient costs in 66.7% of studies. Further research is required to evaluate the economic impact of sepsis bundles beyond the acute care environment, including subacute and RACF, in paediatric and adult populations. In addition, greater attention towards cross-jurisdictional standardisation of cost-impact evaluation methods is needed to facilitate performance benchmarking and meta-analysis of outcomes.