Analysis of the factors influencing hospitalization charges for neonatal congenital heart disease

Background Congenital heart disease(CHD)is the most common congenital anomaly affecting 1.35 million newborns globally every year. Children affected by CHD would normally come across growth failure at a young age. As complex CHD has a high mortality rate,it needs to be corrected as soon as possible after birth.Methods The medical records of infants with diagnosed CHD according to International Classification of Diseases(ICD)10 th Revision codes(January 2009-June 2017)who underwent cardiac surgery were reviewed. In the 431 patients who met the study criteria,their clinical characteristics,outcomes and cost data were collected.Linear regression models were used to determine the hospitalization cost after adjustment for demographic and other risk factors. Results For the 431 patients who met the study criteria,the median hospital stay was 24 days(range 17～34 days),which was not significantly changed over 9 years. The median inflation-adjusted total hospital cost was $80634(range $64585～97831),which was on the increase. The predominant influential factors of hospitalization expenses were hospitalization days,hospitalization deaths,European surgical scores,postsurgical complications and preoperative ventilator assistance. The least amount of hospitalization expenses was spent when hospitalization stay ≤ 10 days and ARISTOTLE surgery total score ≤ 12.25. Hospitalization expenses were related to hospitalization days when it was 10 days to 24 days. The expenses of deaths were higher than the survivors when hospitalization stay was 25 days to 48 days,the number of postsurgical complications ≥ 1.The expenses of deaths reached the highest when the hospital stay ≥ 49 days with the number of postsurgical complications ≥ 3. Conclusion The hospitalization expense of neonate’s CHD has been increasing in recent years. Different hospitalization stays and surgical procedure difficulties,postsurgical complications and hospital deaths could affect the total cost of hospitalization.[S Chin J Cardiol 2019;20(2):86-94]

Background Congenital heart disease(CHD)is the most common congenital anomaly affecting 1.35 million newborns globally every year.Children affected by CHD would normally come across growth failure at a young age.As complex CHD has a high mortality rate,it needs to be corrected as soon as possible after birth.Methods The medical records of infants with diagnosed CHD according to International Classification of Diseases(ICD)10 th Revision codes(January 2009-June 2017)who underwent cardiac surgery were reviewed.In the 431 patients who met the study criteria,their clinical characteristics,outcomes and cost data were collected.Linear regression models were used to determine the hospitalization cost after adjustment for demographic and other risk factors.Results For the 431 patients who met the study criteria,the median hospital stay was 24 days(range 17~34 days),which was not significantly changed over 9 years.The median inflation-adjusted total hospital cost was ￥80634(range ￥ 64585~97831),which was on the increase.The predominant influential factors of hospitalization expenses were hospitalization days,hospitalization deaths,European surgical scores,postsurgical complications and preoperative ventilator assistance.The least amount of hospitalization expenses was spent when hospitalization stay≤10 days and ARISTOTLE surgery total score≤12.25.Hospitalization expenses were related to hospitalization days when it was 10 days to 24 days.The expenses of deaths were higher than the survivors when hospitalization stay was 25 days to 48 days,the number of postsurgical complications≥1.The expenses of deaths reached the highest when the hospital stay≥49 days with the number of postsurgical complications≥3.Conclusion The hospitalization expense of neonate’s CHD has been increasing in recent years.Different hospitalization stays and surgical procedure difficulties,postsurgical complications and hospital deaths could affect the total cost of hospitalization.