Inpatient admissions and costs for adolescents and young adults with congenital heart defects in New York, 2009-2013

Abstract

Background Most individuals born with congenital heart defects (CHDs) survive to adulthood, but healthcare utilization patterns for adolescents and adults with CHDs have not been well described. We sought to characterize the healthcare utilization patterns and associated costs for adolescents and young adults with CHDs.Methods We examined 2009-2013 New York State inpatient admissions of individuals ages 11-30 years with ≥1 CHD diagnosis codes recorded during any admission. We conducted multivariate linear regression using generalized estimating equations to examine associations between inpatient costs and sociodemographic and clinical variables.Results We identified 5,100 unique individuals with 9,593 corresponding hospitalizations over the study period. Median inpatient cost and length of stay (LOS) were $10,307 and 3.0 days per admission, respectively; 55.1% were emergency admissions. Admission volume increased 48.7% from 2009 (1,538 admissions) to 2013 (2,287 admissions), while total inpatient costs increased 111.2% from 2009 ($24.7 million) to 2013 ($52.2 million). Inpatient admissions and costs rose more sharply over the study period for those with non-severe CHDs compared to severe CHDs. Characteristics associated with higher costs were longer LOS, severe CHD, cardiac/vascular hospitalization classification, surgical procedures, greater severity of illness, and admission in New York City.Conclusions This study provides an informative baseline of health care utilization patterns and associated costs among adolescents and young adults with CHDs in New York State.

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

“…114 In New York State, between 2009 and 2013, total costs of inpatient admission for individuals 11 to 30 years of age with CCDs rose from $27.2 million in 2009 to $52.2 million in 2013, increasing faster for those with nonsevere versus severe CCD. 115 A Pediatric Heart Network study found an overall cost reduction for TOF repair of 27% after a clinical practice guideline including early extubation was introduced. Similar cost reduction was not found for patients with aortic coarctation repair.…”

“…In New York State, between 2009 and 2013, total costs of inpatient admission for individuals 11 to 30 years of age with CCDs rose from $27.2 million in 2009 to $52.2 million in 2013, increasing faster for those with nonsevere versus severe CCD. 115…”