Table 5.
Estimated Inpatient Costs among Florida Live-Born Infants with Critical Congenital Heart Disease (CCHD) (n =3603), 1998 to 2007
| CCHD condition | Timely detection
|
Late detection
|
||
|---|---|---|---|---|
| Estimated inpatient costsa ($)
|
Estimated inpatient costsa ($)
|
|||
| Mean (SD) | Median (IQR) | Mean (SD) | Median (IQR) | |
| Hospitalizationsb initiated during neonatal period: <28 days old | ||||
| All (n=3603) | 72,001 (99,396) | 40,918 (85,341) | 31,270 (71,511)c | 4,069 (30,574)c |
| Single CCHD | ||||
| AI/A (n=96) | 70,831 (97,055) | 50,261 (79,433) | 34,719 (37,025)c | 1,445 (10,787)c |
| COA (n=747) | 60,255 (101,814) | 30,198 (59,335) | 19,727 (37,025)c | 4,142 (21,930)c |
| DORV (n=109) | 67,930 (93,274) | 29,764 (97,888) | 32,595 (72,547)c | 2,506 (29,466)c |
| d-TGA (n=260)d | 77,395 (68,130) | 70,216 (44,381) | 25,644 (30,455)c | 11,958 (50,109)c |
| EA (n=87) | 37,961 (82,201) | 7,764 (46,721) | 39,048 (71,024) | 9,284 (36,593) |
| HLHS (n=223)d | 120,592 (141,053) | 78,778 (163,537) | 51,034 (56,020)c | 36,887 (80,209)c |
| PA (n=96)d | 75,466 (90,202) | 47,312 (95,093) | 51,431 (112,822) | 16,840 (49,947) |
| SV (n=32) | 52,919 (73,127) | 29,572 (70,526) | 69,321 (110,635) | 36,195 (71,927) |
| TA (n=101)d | 68,672 (76,123) | 51,385 (81,848) | 38,905 (92,647)c | 7,868 (39,236)c |
| TAPVC (n=92)d | 79,990 (66,603) | 64,800 (72,601) | 26,653 (48,970)c | 1,173 (46,572)c |
| TOF (n=745)d | 39,094 (75,537) | 8,152 (36,948) | 20,347 (65,175)c | 1,760 (9,224)c |
| TRA (n=122)d | 43,277 (99,801) | 12,458 (46,217) | 28,588 (59,351) | 3,644 (29,647) |
| Multiple CCHD (n=893) | 96,900 (104,751) | 72,628 (97,745) | 61,763 (106,949)c | 11,521 (89,308)c |
| Hospitalizationsb initiated during infancy: <365 days old | ||||
| All (n=3603) | 100,150 (124,511) | 67,727 (104,495) | 69,486 (106,781)c | 38,149 (60,545)c |
| Single CCHD | ||||
| AI/A (n=96) | 78,724 (101,145) | 61,946 (98,619) | 96,164 (282,737) | 31,176 (63,680) |
| COA (n=747) | 72,213 (111,655) | 36,452 (74,704) | 46,917 (76,835)c | 25,922 (34,264)c |
| DORV (n=109) | 83,430 (105,109) | 49,491 (118,201) | 77,762 (87,433) | 52,877 (54,121) |
| D-TGA (n=260)d | 82,641 (69,402) | 72,390 (46,223) | 55,669 (38,166) | 53,154 (72,719) |
| EA (n=87) | 53,336 (114,959) | 7,764 (50,199) | 55,650 (71,197) | 34,034 (73,467) |
| HLHS (n=223)d | 142,500 (161,243) | 93,598 (207,094) | 74,962 (68,789) | 56,338 (111,825) |
| PA (n=96)d | 92,438 (115,600) | 56,644 (115,141) | 83,702 (122,233) | 72,532 (87,352) |
| SV (n=32) | 64,237 (75,736) | 48,296 (90,986) | 113,922 (112,081) | 102,813 (64,586) |
| TA (n=101)d | 95,820 (136,630) | 65,500 (75,337) | 60,140 (90,736) | 37,424 (47,090) |
| TAPVC (n=92)d | 90,460 (76,563) | 65,891 (88,155) | 63,281 (51,501) | 47,702 (42,543) |
| TOF (n=745)d | 74,226 (102,781) | 42,295 (64,557) | 53,945 (72,871) | 33,492 (33,449) |
| TRA (n=122)d | 61,028 (136,025) | 30,726 (56,279) | 89,627 (107,253)c | 59,455 (52,711)c |
| Multiple CCHD (n=893) | 147,189 (138,378) | 110,709 (128,431) | 132,917 (145,934)c | 88,395 (118,595)c |
Presented as 2011 values (U.S. Bureau of Labor Statistics, 2012). Estimated costs calculated as total inpatient facility charges multiplied by the Florida average hospital cost-to-charge ratio (0.281 in 2009) (AHRQ, 2012). Inpatient charges include all hospital facility charges (excludes professional fees): Pharmacy, medical and surgical supply, laboratory, radiology and other imaging, cardiology, operating room, anesthesia, recovery room, emergency room (if an inpatient admission originated in the emergency room), treatment or observation room (if a visit resulted in an inpatient admission) charges (AHCA, 2012).
Hospitalizations were assessed as continuous episodes of hospital care, regardless of whether a transfer occurred. Multiple admission records were merged into one if an infant was admitted to a hospital on the same day as a discharge from a previous admission, or if the infant was admitted to a hospital on the day after a previous discharge with an accompanying “transfer” code. The level of birth hospitalization nursery care (I, III, or III [highest])]) (American Academy of Pediatrics Committee on Fetus and Newborn, 2004) that an infant received was coded as the highest facility level if a transfer occurred.
p <0.05 for test of timely versus late detection (Mann-Whitney-Wilcoxon rank sum test).
Conditions identified as primary targets for pulse oximetry screening (Mahle et al., 2009; Kemper et al., 2011).
IQR, Interquartile range; AI/A, aortic interruption/atresia/hypoplasia; COA, coarctation/hypoplasia of aortic arch; DORV, double-outlet right ventricle; d-TGA dextro-transposition of the great arteries; EA, Ebstein anomaly; HLHS, hypoplastic left heart syndrome; PA, pulmonary atresia; SV, single ventricle; TA, truncus arteriosus; TAPVC, total anomalous pulmonary venous connection; TOF, tetralogy of Fallot; TRA, tricuspid atresia.