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Some states have implemented newborn screening for critical congenital heart defects (CCHDs). Current healthcare resource use for this population has not been well described. We evaluated hospital resource use among pediatric hospital admissions with CCHDs.
We analyzed data from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project 2009 Kids’ Inpatient Database to estimate pediatric hospital admissions (≤ 20 years), charges and length of stay (LOS). We included admissions with any ICD-9-CM code indicating at least one of 12 CCHD types. We excluded uncomplicated hospital births, CCHD admissions with a chromosomal abnormality, and admissions missing age, charge, or LOS. We examined median charges and LOS for all admissions and those with a CCHD.
Of 7,370,203 pediatric admissions, 4,467,044 met our inclusion criteria, including 25,658 with any CCHD diagnosis. Median charges were about 15 times higher for infants with CCHDs and about three times higher among young adults (age 11–20) compared to all admissions (Table). Median LOS was about three times higher for infants with CCHDs and about 1.5 times higher among young adults compared to all admissions.
CCHD admissions represent 0.6% of pediatric admissions and have disproportionately higher charges and longer LOS. Newborn screening for CCHDs could reduce late CCHD diagnosis and might decrease hospital visits, mortality, and morbidity with timely treatment and management.
|All pediatric admissions||Pediatric admissions with a CCHD1 diagnosis|
|Age (Years)||Total hospital stays||Median charges (dollars) for each hospital stay (IQR)2||Median length of stay (days) for each hospital stay (IQR)2||Total hospital stays||Median charges (dollars) for each hospital stay (IQR)2||Median length of stay (days) for each hospital stay (IQR)2|
|< 1||1,765,164||5,628 (2,683–17,133)||2.1 (1.3–3.9)||16,883||83,429 (19,691–221,662)||6.6 (2.1–17.9)|
|1–5||627,338||9,336 (5,218–18,332)||1.6 (0.7–2.8)||5,163||58,896 (20,013–127,227)||4.3 (1.6–8.6)|
|6–10||336,623||12,842 (6,918–24,570)||1.8 (0.8–3.4)||1,410||46,899 (19,124–109,922)||3.1 (1.0–6.0)|
|11–15||420,190||14,430 (7,920–27,715)||2.1 (1.0–4.4)||1,112||46,600 (19,258–94,519)||3.0 (0.9–5.6)|
|16–20||1,317,729||11,288 (6,988–20,000)||1.9 (1.2–3.0)||1,090||34,268 (14,080–92,791)||2.9 (1.1–5.5)|
|Total||4,467,044||9,483 (4,614–20,239)||1.9 (1.1–3.5)||25,658||69,453 (19,331–173,785)||5.2 (1.8–13.4)|
1 CCHDs (ICD-9-CM) include the 12 primary and secondary targets of current newborn screening practices: hypoplastic left heart syndrome (746.7), pulmonary atresia (746.01), tetralogy of Fallot (745.2), transposition of the great arteries (745.10), tricuspid atresia (746.1), truncus arteriosus (745.0), total anomalous pulmonary venous return (747.41), coarctation of the aorta (747.10), double outlet right ventricle (745.11), Ebstein's anomaly (746.2), interrupted aortic arch (747.11), single ventricle (745.3).
2 Interquartile Range
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Cardiology Solutions: Quality and Outcomes
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1120M-138
- 2013 American College of Cardiology Foundation