Author + information
- Sara K. Pasquali,
- Xia He,
- Marshall Jacobs,
- Samir Shah,
- Eric D. Peterson,
- Matthew Hall,
- J. William Gaynor,
- Kevin D. Hill,
- Karl F. Welke,
- John E. Mayer,
- Jeffrey P. Jacobs and
- Jennifer S. Li
Prior studies of hospital costs for pediatric heart surgery relied on administrative data. Linkage with clinical data allows more detailed case ascertainment, risk adjustment, and assessment of complications and outcomes; and may improve our understanding of variation in resource utilization and mediating factors in this era of rising healthcare costs.
Clinical data from The Society of Thoracic Surgeons Database were linked to cost data from the Pediatric Health Information Systems Database (2006-10). Center variation in hospital costs, adjusted for patient characteristics, was assessed for 9 operations of varying complexity using Bayesian methods.
12,718 operations (27 centers) were included. Costs increased with case complexity (Table). Wide variation between hospitals in adjusted costs was observed across operations, and was greatest for Tetralogy of Fallot repair (9-fold variation). High volume centers had lower costs for the most complex procedures (arterial switch, truncus, Norwood). Hospitals with longer post-op length of stay (LOS) and higher complication rates had higher costs; these variables explained an average of 28% of the variation in cost (range 5-50%).
Hospital costs vary widely across institutions, and are related in part to differences in LOS and complication rates. Further study of the cost-outcome relationship is needed to develop strategies to reduce resource utilization while optimizing patient outcomes.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Congenital Cardiology Solutions: Congenital Heart Surgery
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1205M-137
- 2013 American College of Cardiology Foundation