Rehospitalizations for ambulatory care sensitive conditions in sepsis survivors- a nationwide cohort study using health claims data 2016-2019.

Purpose: Sepsis survivors suffer from frequent rehospitalizations, of which a certain proportion is considered preventable by timely and adequate management in the outpatient setting (= ambulatory care sensitive conditions, ACSC). We aimed to assess the frequency of and risk factors for ACSC and infection-associated ACSC rehospitalization among sepsis survivors.

Methods: Population-based, retrospective cohort study among using nationwide health claims data of the "AOK- die Gesundheitskasse". Sepsis patients with inpatient treatment in 2016-2019 were identified using ICD-codes. Among sepsis hospital survivors, ACSC and infection-related ACSC were identified. Patient-related risk factors for ACSC were assessed by a multiple logistic regression analysis.

Results: We included 347,826 sepsis patients and 234,874 sepsis hospital survivors. A total of 53.2% and 21.3% of sepsis survivors had at least one ACSC and infection-related ACSC rehospitalizations in the 12-months post-discharge, respectively. ACSC rehospitalizations often occurred closely after discharge and more frequently affected older, male, care dependent patients as well as those living in rural areas.

Conclusion: ACSC are common among sepsis survivors. This underlines to need for structured aftercare programs and interventions in these patients, particularly for ACSC risk groups which comprise older, male, care dependent patients in rural areas.