Costs vary widely for care of children with congenital heart defects across US hospitals

February 24, 2014, University of Michigan Health System

Costs of care differ significantly across hospitals for children born with heart defects, according to new research led by a University of Michigan researcher. Congenital heart defects are known to be the most common birth defects, impacting nearly 1 in every 100 births.

The cost of care for children with undergoing surgical repair varied as much as nine times across a large group of U.S. children's hospitals, says lead author Sara K. Pasquali, M.D., M.H.S., associate professor of pediatrics at the University of Michigan Medical School and C.S. Mott Children's Hospital Congenital Heart Center.

"Before we conducted this study study, there was limited information on the costs associated with caring for these children, even though this is one of the most common and expensive conditions treated across children's hospitals," says Pasquali about the research published today in the journal Pediatrics.

Pasquali and her co-authors studied 12,718 patients from 27 U.S. children's hospitals and found wide variation between hospitals in costs associated with for nearly every operation examined. These differences were apparent even after accounting for differences in patient characteristics across hospitals, and for regional differences in cost.

The investigators also evaluated potential reasons for this wide variation across hospitals. They found that hospitals with higher case volumes had significantly lower costs for the most complex operations.

In addition, the researchers also found that the highest cost hospitals had higher rates of post-operative complications, and their patients tended to stay in the hospital for a longer period of time after surgery.

For example, the study found that hospitals with the highest costs after the Norwood operation had double the rate of major complications compared with hospitals with the lowest costs. In addition, the higher cost hospitals had an average length of stay after the Norwood operation nearly twice as long as the low cost hospitals. Norwood operations are performed on patients with hypoplastic left heart syndrome – a birth defect that ranks at the top of the list for highest health care resource utilization.

"In this era of rising health care costs, there is an increasing need to provide care more efficiently and reduce costs." says Pasquali. "The cost variations we found in this study suggest there is ample room for improvement, and also suggest a link between high quality care and lower cost. For example, initiatives aimed at reducing length of stay and complication rates have the potential to both improve quality and also lower costs."

"More research is needed in order to better understand how hospitals may achieve improvements in this area," says Pasquali. "Data from our institution and others suggest that standardization of practice may be important."

For example a recent study conducted by the Michigan Congenital Heart Center showed that standardizing care for children who develop a chylothorax (fluid accumulation) after surgery led to earlier diagnosis, significantly reduced time on the ventilator, and decreased length of stay.

"Better ways to share these best practices among hospitals is needed, Pasquali says. " We hope that this research is a catalyst to engage hospitals in working together to both improve quality and lower costs of care for these patients."

Explore further: Adult congenital heart patients with highest surgery costs more likely to die in hospital

More information: Pediatrics DOI: 10.1542/peds.2013-2870

Related Stories

Adult congenital heart patients with highest surgery costs more likely to die in hospital

October 18, 2011
Higher surgical costs for adult congenital heart patients is associated with higher rates of inpatient death compared to surgical admissions that incur lower costs, according to a study in Circulation: Quality and Outcomes, ...

High volume of severe sepsis patients may result in better outcomes

January 17, 2014
A recent study led by Boston University School of Medicine (BUSM) shows that "practice may make perfect" when it comes to caring for patients with severe sepsis. The study showed that patients admitted to academic medical ...

Many US hospitals fall short in preventing infections

February 19, 2014
(HealthDay)—Many U.S. hospitals don't follow rules meant to protect patients from preventable and potentially deadly infections, a new study shows.

Low-mortality hospitals better with heart surgery complications

June 6, 2013
(HealthDay)—Hospitals with low mortality rates for adults undergoing cardiac surgery are superior in rescuing patients from postoperative complications, according to research published in the June issue of the Annals of ...

State deregulation of open-heart surgery beneficial to patients

October 3, 2012
(Medical Xpress)—Certificate of Need, a form of state government regulation designed to keep mortality rates and health care costs down, appears to do neither for heart bypass surgery, according to a health economics researcher ...

Hospital readmission rates linked with quality of surgical care

September 18, 2013
Reducing hospital readmission rates is an important clinical and policy priority but whether those rates really measure the quality of hospital care isn't clear. In a new study, researchers from Harvard School of Public Health ...

Recommended for you

Baby brains help infants figure it out before they try it out

January 17, 2018
Babies often amaze their parents when they seemingly learn new skills overnight—how to walk, for example. But their brains were probably prepping for those tasks long before their first steps occurred, according to researchers.

NeuroNext biomarker study explores natural history of infantile-onset SMA

January 9, 2018
Research led by The Ohio State University Wexner Medical Center to define the natural history of infantile-onset spinal muscular atrophy (SMA) has been "critical" to accelerate the development of effective therapies and hasten ...

No link between childhood lead levels, later criminality

December 27, 2017
(HealthDay)— Exposure to higher levels of lead during early childhood can affect neurological development—but does that mean affected kids are doomed to delinquency?

Early puberty in girls may take mental health toll

December 26, 2017
(HealthDay)—A girl who gets her first menstrual period early in life—possibly as young as 7—has a greater risk for developing depression and antisocial behaviors that last at least into her 20s, a new study suggests.

Technology not taking over children's lives despite screen-time increase

December 21, 2017
With children spending increasing amounts of time on screen-based devices, there is a common perception that technology is taking over their lives, to the detriment and exclusion of other activities. However, new Oxford University ...

Higher blood sugar in early pregnancy raises baby's heart-defect risk

December 15, 2017
Higher blood sugar early in pregnancy raises the baby's risk of a congenital heart defect, even among mothers who do not have diabetes, according to a study led by researchers at the Stanford University School of Medicine.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.