Sepsis is one of the costliest and most common causes of inpatient stays and contributes to approximately 350,000 deaths per year. This study explores differences in sepsis mortality rates between rural and urban hospitals, linking factors such as resource constraints and transfer delays. The study uses a retrospective cohort design, analyzing Nationwide Readmissions Database data from 2016 to 2021 to track sepsis-related hospital discharges and mortality, including postoperative sepsis and septic shock. It examines differences in sepsis prevalence, hospital stays, length of stay, mortality, and discharge disposition. The analysis also explores the role of inter-hospital transfers, particularly their effects on treatment delays and sepsis outcomes, with a focus on vulnerable rural populations.

Key objectives include understanding rural-urban variations in sepsis prevalence and outcomes, assessing the impact of socioeconomic and demographic factors, including the influence of racial and ethnic disparities on sepsis treatment and mortality. Study findings will inform policies related to access to timely, high-quality sepsis care and identify strategies to improve healthcare outcomes across diverse settings.