Wan-Hsiang Hsu1, Kristin M Sommerhalter1, Claire E McGarry1, Sherry L Farr2, Karrie F Downing2, George K Lui3, Ali N Zaidi4, Daphne T Hsu5, Alissa R Van Zutphen1,6. 1. New York State Department of Health, Bureau of Environmental & Occupational Epidemiology, Albany, New York, USA. 2. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 3. Divisions of Cardiovascular Medicine and Pediatric Cardiology, Stanford School of Medicine, Stanford, California, USA. 4. Sinai Adult Congenital Heart Disease Program, Mount Sinai Cardiovascular Institute & The Pediatric Heart Center, New York, New York, USA. 5. Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, USA. 6. University at Albany School of Public Health, Rensselaer, New York, USA.
Abstract
OBJECTIVES: Most individuals born with congenital heart defects (CHDs) survive to adulthood, but healthcare utilization patterns for adolescents and adults with CHDs have not been well described. We sought to characterize the healthcare utilization patterns and associated costs for adolescents and young adults with CHDs. METHODS: We examined 2009-2013 New York State inpatient admissions of individuals ages 11-30 years with ≥1 CHD diagnosis codes recorded during any admission. We conducted multivariate linear regression using generalized estimating equations to examine associations between inpatient costs and sociodemographic and clinical variables. RESULTS: We identified 5,100 unique individuals with 9,593 corresponding hospitalizations over the study period. Median inpatient cost and length of stay (LOS) were $10,720 and 3.0 days per admission, respectively; 55.1% were emergency admissions. Admission volume increased 48.7% from 2009 (1,538 admissions) to 2013 (2,287 admissions), while total inpatient costs increased 91.8% from 2009 ($27.2 million) to 2013 ($52.2 million). Inpatient admissions and costs rose more sharply over the study period for those with nonsevere CHDs compared to severe CHDs. Characteristics associated with higher costs were longer LOS, severe CHD, cardiac/vascular hospitalization classification, surgical procedures, greater severity of illness, and admission in New York City. CONCLUSION: This study provides an informative baseline of health care utilization patterns and associated costs among adolescents and young adults with CHDs in New York State. Structured transition programs may aid in keeping this population in appropriate cardiac care as they move to adulthood.
OBJECTIVES: Most individuals born with congenital heart defects (CHDs) survive to adulthood, but healthcare utilization patterns for adolescents and adults with CHDs have not been well described. We sought to characterize the healthcare utilization patterns and associated costs for adolescents and young adults with CHDs. METHODS: We examined 2009-2013 New York State inpatient admissions of individuals ages 11-30 years with ≥1 CHD diagnosis codes recorded during any admission. We conducted multivariate linear regression using generalized estimating equations to examine associations between inpatient costs and sociodemographic and clinical variables. RESULTS: We identified 5,100 unique individuals with 9,593 corresponding hospitalizations over the study period. Median inpatient cost and length of stay (LOS) were $10,720 and 3.0 days per admission, respectively; 55.1% were emergency admissions. Admission volume increased 48.7% from 2009 (1,538 admissions) to 2013 (2,287 admissions), while total inpatient costs increased 91.8% from 2009 ($27.2 million) to 2013 ($52.2 million). Inpatient admissions and costs rose more sharply over the study period for those with nonsevere CHDs compared to severe CHDs. Characteristics associated with higher costs were longer LOS, severe CHD, cardiac/vascular hospitalization classification, surgical procedures, greater severity of illness, and admission in New York City. CONCLUSION: This study provides an informative baseline of health care utilization patterns and associated costs among adolescents and young adults with CHDs in New York State. Structured transition programs may aid in keeping this population in appropriate cardiac care as they move to adulthood.
Authors: Kristin M Sommerhalter; Tabassum Z Insaf; Tugba Akkaya-Hocagil; Claire E McGarry; Sherry L Farr; Karrie F Downing; George K Lui; Ali N Zaidi; Alissa R Van Zutphen Journal: Birth Defects Res Date: 2017-11-01 Impact factor: 2.344
Authors: Kristin Bergman; Nina E Forestieri; Vito L Di Bona; Scott D Grosse; Cynthia A Moore Journal: Birth Defects Res Date: 2022-01-04 Impact factor: 2.661
Authors: Judson A Moore; Shreya S Sheth; Wilson W Lam; Alexander J Alexander; John C Shabosky; Andre Espaillat; Donna K Lovick; Nicole S Broussard; Karla J Dyer; Keila N Lopez Journal: Pediatr Cardiol Date: 2022-01-21 Impact factor: 1.838