Abstract 11013: Resource Utilization for Non-Cardiac Hospital Admissions in Patients With Single Ventricle Congenital Heart Disease

Abstract

Background: Patients with single ventricle (SV) congenital heart disease (CHD) incur high hospital costs during staged surgical palliation. However, resource utilization for non-cardiac admissions in SV patients has not been reported. This study sought to compare costs for common non-cardiac hospital admissions between SV patients and patients without CHD. Methods: A retrospective review of hospital discharge data from the University HealthSystem Consortium (UHC) from January 2011 through December 2013 was performed. UHC collects discharge data from 120 academic institutions and 302 affiliated hospitals. The database was queried for patients <18 years of age with ICD-9 codes for SV lesions: hypoplastic left heart syndrome (746.7), tricuspid atresia (746.1) or common ventricle (745.3). Neonates (<30 days old) were excluded to eliminate hospitalizations for Stage 1 surgical palliation. Primary diagnosis, direct cost, length of stay (LOS), ICU admission rate and mortality data were obtained. The eight most common non-cardiac admission diagnoses were compared between SV patients and non-CHD patients using t-test and Fisher’s exact test, as appropriate. Results: The non-cardiac admission diagnoses, with ICD-9 codes, and comparisons between SV and non-CHD patients are shown in the Table. Total direct cost, LOS and ICU admission rate were higher for SV patients for all diagnoses with the exception of LOS for failure to thrive, which was not different between groups. Notably, hospital mortality was markedly higher for SV patients admitted for RSV bronchiolitis or pneumonia. Conclusions: Hospital costs for common non-cardiac diagnoses are higher for patients with SV CHD. As long-term survival of SV CHD patients increase they will utilize a disproportionate amount of medical dollars, as our study shows. Further characterization of SV CHD patient costs will be important so steps can be taken to reduce or prevent hospitalization in these patients.