Resource Utilization for Noncardiac Admissions in Pediatric Patients With Single Ventricle Disease

• Published in: The American journal of cardiology Vol. 117; no. 10; pp. 1661 - 1666
• Main Authors: Thomas, Ian D., Seckeler, Michael D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.05.2016; Elsevier Limited
• Subjects: Adolescent; Arizona - epidemiology; Child; Child, Preschool; Congenital diseases; Emergency medical care; Female; Follow-Up Studies; Health Care Costs - statistics & numerical data; Health Resources - utilization; Heart Defects, Congenital - economics; Heart Defects, Congenital - mortality; Heart Defects, Congenital - therapy; Heart Ventricles - abnormalities; Hospital Mortality - trends; Hospitalization; Hospitalization - economics; Humans; Infant; Infant, Newborn; Male; Mortality; Patient admissions; Retrospective Studies; Utilization Review
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.02.043

Patients with single ventricle (SV) congenital heart disease (CHD) incur high hospital costs during staged surgical palliation. Health care resource utilization for noncardiac admissions in patients with SV has not been reported. This study sought to compare costs and outcomes for common noncardiac hospital admissions between patients with SV and patients without CHD. Hospital discharge data from the University Health System Consortium from January 2011 to December 2013 was queried for patients aged ≤18 years with International Classification of Diseases, Ninth Revision (ICD-9) codes for SV lesions: hypoplastic left heart syndrome (746.7), tricuspid atresia (746.1), or common ventricle (745.3). Primary diagnosis, direct cost, length of stay (LOS), intensive care unit admission rate and mortality data were obtained. The 10 most common noncardiac admission diagnoses were compared between patients with SV and patients without CHD using t test and Fisher's exact test. Total direct cost, LOS, and intensive care unit admission rate were higher for patients with SV for all diagnoses with the exception of LOS for dehydration, which was not different between groups. Hospital mortality was significantly higher for patients with SV admitted for acute kidney injury, esophageal reflux, failure to thrive, respiratory syncytial virus bronchiolitis and pneumonia. In conclusion, our study demonstrates that patients with SV CHD admitted with noncardiac diagnoses have higher health care resource utilization compared to those without CHD. As long-term survival increases, it can be expected that this patient group will use a disproportionate amount of medical dollars. Further characterization of costs will be important so steps can be taken to reduce or prevent hospitalization in these patients.