Abstract
Adults with congenital heart disease (CHD) are a rapidly increasing population and their impact on healthcare resources is not fully understood. The purpose of this study was to describe the costs of hospitalizations for non-cardiac disease for adults with CHD. We conducted a retrospective review of hospital discharge data from the University HealthSystem Consortium Clinical Data Base/Resource Manager from January 2011 through December 2013. Patients were ≥ 18 years old at admission with any ICD-9 code for moderate or high severity CHD; cardiac surgical admissions were excluded. The comparison group consisted of patients ≥ 18 years old with no ICD-9 codes for any severity CHD. There were 9,169,700 non-CHD, 28,224 moderate CHD, and 3045 high severity CHD hospital admissions. Total length of stay was longer for acute kidney injury, depressive disorder, esophageal reflux, and obstructive sleep apnea for any severity CHD; ICU admission rates were higher for all diagnoses with any severity CHD. Mean observed direct costs were higher for all diagnoses for moderate CHD and all diagnoses except dehydration, type 2 diabetes, obesity, and obstructive sleep apnea for high severity CHD. This review identified significantly increased hospitalization costs for adults with moderate and high severity CHD who are admitted for non-cardiac medical conditions not associated with concomitant cardiac surgical procedures. Admissions with CHD diagnoses had higher ICU admission rates, longer lengths of stay, and higher mortality for most non-cardiac admission diagnoses. These data will add to our understanding of the economic impact of adults with CHD.
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References
O’Leary JM, Siddiqi OK, de Ferranti S et al (2013) The changing demographics of congenital heart disease hospitalizations in the United States, 1998 through 2010. JAMA 309:984–986
Opotowsky AR, Siddiqi OK, Webb GD (2009) Trends in hospitalizations for adults with congenital heart disease in the U.S. J Am Coll Cardiol 54:460–467
Verheugt CL, Uiterwaal CS, van der Velde ET et al (2010) The emerging burden of hospital admissions of adults with congenital heart disease. Heart 96:872–878
Seckeler MD, Moe TG, Thomas ID et al (2015) Hospital resource utilization for common noncardiac diagnoses in adult survivors of single cardiac ventricle. Am J Cardiol 116:1756–1761
Gutgesell HP, Hillman DG, McHugh KE et al (2011) Use of an administrative database to determine clinical management and outcomes in congenital heart disease. World J Pediatr Congenit Heart Surg 2:593–596
Marelli AJ, Mackie AS, Ionescu-Ittu R et al (2007) Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 115:163–172
Seckeler MD, Thomas ID, Andrews J et al (2016) A review of the economics of adult congenital heart disease. Expert Rev Pharmacoecon Outcomes Res 16:58–96
Warnes CA, Liberthson R, Danielson GK et al (2001) Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 37:1170–1175
McDowell B, Hooper A. (2014) UHC’s clinical data base (CDB) observed cost methodology. https://amc.vizientinc.com/docs/7777-21-6817_Observed_Cost_Methodology_2014_Risk_Model.pdf. Accessed 10 Oct 2017
Khairy P, Ionescu-Ittu R, Mackie AS et al (2010) Changing mortality in congenital heart disease. J Am Coll Cardiol 56:1149–1157
Verheugt CL, Uiterwaal CS, Grobbee DE et al (2008) Long-term prognosis of congenital heart defects: a systematic review. Int J Cardiol 131:25–32
Rodriguez FH, Moodie DS, Parekh DR et al (2013) Outcomes of heart failure-related hospitalization in adults with congenital heart disease in the United States. Congenit Heart Dis 8:513–519
Mackie AS, Pilote L, Ionescu-Ittu R et al (2007) Health care resource utilization in adults with congenital heart disease. Am J Cardiol 99:839–843
Collins RT, Fram RY, Tang X et al (2014) Hospital utilization in adults with single ventricle congenital heart disease and cardiac arrhythmias. J Cardiovasc Electrophysiol 25:179–186
Verheugt CL, Uiterwaal CS, van der Velde ET et al (2010) Mortality in adult congenital heart disease. Eur Heart J 31:1220–1229
Zomer AC, Uiterwaal CS, van der Velde ET et al (2011) Mortality in adult congenital heart disease: are national registries reliable for cause of death? Int J Cardiol 152:212–217
Mylotte D, Pilote L, Ionescu-Ittu R et al (2014) Specialized adult congenital heart disease care: the impact of policy on mortality. Circulation 129:1804–1812
Frohnert BK, Lussky RC, Alms MA et al (2005) Validity of hospital discharge data for identifying infants with cardiac defects. J Perinatol 25:737–742
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The need for informed consent was waived by the University of Arizona Institutional Review Board.
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Seckeler, M.D., Thomas, I.D., Andrews, J. et al. Higher Cost of Hospitalizations for Non-cardiac Diagnoses in Adults with Congenital Heart Disease. Pediatr Cardiol 39, 437–444 (2018). https://doi.org/10.1007/s00246-017-1770-y
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DOI: https://doi.org/10.1007/s00246-017-1770-y