The population of adults with congenital heart disease (ACHD) in the United States
is growing rapidly with concomitant increases in care costs. We sought to define the
variables having the greatest influence on annual cost of inpatient care in patients
with ACHD in the United States. To do so, we conducted a retrospective analysis of
admissions in patients >18 years old with a 3-digit International Classification of Disease, Ninth Revision, code of 745 to 747 from the State Inpatient Databases of Arkansas (2008 to 2010),
California (2003 to 2012), Florida (2005 to 2012), Hawaii (2006 to 2010), Nebraska
(2003 to 2011), and New York (2005 to 2012). We selected variables we believed would
have the greatest effect on care costs and built a series of multivariable regression
models grouping patients by congenital lesion to examine the relative contribution
of the specified variables to total annual inpatient cost. We analyzed a total of
68,314 patients aged 57 ± 18.6 years, 51% of whom were women. The multivariable regression
model had an overall R2 of 0.35. Readmission was responsible for 10.3% of annual inpatient cost among all
patients with ACHD and had the greatest effect on inpatient care cost for each congenital
lesion except Eisenmenger syndrome and conotruncal abnormalities, for both of which
it was the second most significant contributor. Other major contributors to annual
inpatient care costs included length of stay and operative procedures. In conclusion,
rehospitalization is the most significant contributor to annual inpatient cost for
individual patients with ACHD in the United States, regardless of underlying anatomy.
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Article info
Publication history
Published online: March 19, 2016
Accepted:
March 1,
2016
Received in revised form:
March 1,
2016
Received:
February 11,
2016
Footnotes
Research reported in this publication was supported by the Washington University Institute of Clinical and Translational Sciences, Saint Louis, MO, grant UL1 TR000448 from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH), Bethesda, MD. The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.
See page 1825 for disclosure information.
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Copyright
© 2016 Elsevier Inc. All rights reserved.
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- Erratum for “Lesion-Specific Factors Contributing to In-hospital Costs in Adults With Congenital Heart Disease” Am J Cardiol 2016;117:1821-1825American Journal of CardiologyVol. 120Issue 2
- PreviewOur study, Lesion-Specific Factors Contributing to In-hospital Costs in Adults With Congenital Heart Disease published June 2016 in The American Journal of Cardiology, is an analysis of the State Inpatient Database (SID), a restricted-access, publicly available dataset that is maintained by the Agency for Healthcare Research and Quality (AHRQ). One of the provisions of the SID Data Use Agreement (DUA), which I signed when purchasing the data, is that no data observation involving less than or equal to 10 observations is to be published.
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