Author + information
- Jamie Colombo,
- Michael Spaeder,
- Jeffrey Vergales and
- Michael Hainstock
Background: Cardiac catheterization (CC) is performed in patients with single ventricle congenital heart disease (SVCHD) to aid in hemodynamic assessment, intervention and surgical planning. Outpatient CC reduces anxiety to patients and families and decreases cost. Given the morbidity and mortality associated with interstage SVCHD, substantial post-procedural variability exists and best practices remain unclear. The objective of this study was to investigate the economic implications of outpatient cath with potential readmission vs. universal 23-hour overnight observation in infants with SVCHD.
Methods: We performed a retrospective review of patients less than one year of age with SVCHD who underwent CC from 2007-2015 at our institution. A decision-tree based cost analysis was performed utilizing known procedural and in-hospital costs. Stochastically-based sensitivity analyses were then performed to challenge base-case estimates.
Results: The baseline cost of same day discharge + probability of readmission cost was less than the cost for 23-hour observation + the probability of accruing a longer hospitalization, given our readmission rate of 3% ($5,660 vs. $10,003). The readmission rate of outpatient CC would need to increase to 71% for costs to equilibrate to that of universal 23-hour observation (Figure 1).
Conclusions: Outpatient CC for infants with SVCHD demonstrates lower attributed cost compared to universal 23-hour observation, given the low rate of readmission.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Heart Disease: Advances in Quality Improvement for Pediatric Cardiac Care
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1143-017
- 2017 American College of Cardiology Foundation