Abstract
Introduction: According to Reports on the Prevention and Control of Birth Defects in China, the total lifelong economic burden of new congenital heart diseases (CHD) cases was more than 12.6 billion Chinese Yuan. We aim at exploring the economic burden driven by congenital heart surgery and filling the gap in the health economics in China. Methods: We used data from CDCHS database (Registry No. ChiCTR1800014577) to prospectively analyze the economic burden of congenital heart surgery. The total expenditures were divided into eleven subjects and classified by STAT category, year, and different types of CHD. Stepwise multivariable linear regression model was utilized to analyze the contributing factor to the total expenditure. National economic data was accessed to better describe the burden. Results: A total of 6568 hospitalizations were enrolled from 2018 to 2020. The median of total expenditure of all enrolled patients during hospitalization was 63,129.14 (≈9,910.52 USD), and significant cost-related difference was defined among the five STAT categories (P<0.001) with the lowest in STAT-1 (55,720.43, ≈8,747.46 USD) and highest in STAT-5 (190,587.01, ≈29,919.94 USD). The median total costs during the 3-year 2018 to 2020 period were 57,248.72 (≈8,987.38 USD), 63,423.45 (≈9,956.74 USD) and 67,867.37 (≈10,654.39 USD), respectively. Multivariable linear regression model showed that STAT category, complication, emergent operation and delay sternal closure were the major contributing factor to the total expenditure. Conclusions: For the first time, the economic burden of congenital heart surgery in China is delineated not only in terms of total expenditure but also the detail components. Also, the current healthcare policies in China were analyzed, and combined with the expenditure information, this analysis provides substantial information about specific factors driving to the economic burden with the purpose of aiding policy adjustments.
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