Cumulative In-Hospital Costs Associated With Single-Ventricle Palliation

被引：4

作者：

O'Byrne, Michael L. ^{[1
,2
,3
,4
,5
,30
]}

McHugh, Kimberly E. ^{[6
]}

Huang, Jing ^{[7
]}

Song, Lihai ^{[8
]}

Griffis, Heather ^{[8
]}

Anderson, Brett R. ^{[9
]}

Bucholz, Emily M. ^{[10
,11
]}

Chanani, Nikhil K. ^{[12
,13
]}

Elhoff, Justin J. ^{[14
,15
,16
]}

Handler, Stephanie S. ^{[17
]}

Jacobs, Jeffery P. ^{[18
,19
]}

Li, Jennifer S. ^{[20
]}

Lewis, Alan B. ^{[21
]}

Mccrindle, Brian W. ^{[22
]}

Pinto, Nelangi M. ^{[23
,24
]}

Sassalos, Peter ^{[25
,26
]}

Spar, David S. ^{[27
,28
]}

Pasquali, Sara K. ^{[29
]}

Glatz, Andrew C. ^{[1
,2
,3
]}

机构：

[1] Univ Penn, Childrens Hosp Philadelphia, Div Cardiol, Philadelphia, PA USA

[2] Univ Penn, Perelman Sch Med, Dept Pediat, Philadelphia, PA USA

[3] Childrens Hosp Philadelphia, Ctr Pediat Clin Effectiveness, Philadelphia, PA USA

[4] Univ Penn, Leonard Davis Inst Hlth Econ, Perelman Sch Med, Philadelphia, PA USA

[5] Univ Penn, Cardiovasc Outcomes Qual & Evaluat Res Ctr, Perelman Sch Med, Philadelphia, PA USA

[6] Med Univ South Carolina, Div Cardiol, Charleston, SC USA

[7] Perelman Sch Med, Ctr Clin Epidemiol & Biostat, Dept Biostat, Philadelphia, PA USA

[8] Childrens Hosp Philadelphia, Dept Biomed & Hlth Informat, Data Sci & Biostat Unit, Philadelphia, PA USA

[9] Columbia Univ, New York Presbyterian Morgan Stanley Childrens Hos, Irving Med Ctr, Div Cardiol, New York, NY USA

[10] Childrens Hosp Boston, Dept Cardiol, Boston, MA USA

[11] Harvard Univ, Med Sch, Boston, MA USA

[12] Childrens Healthcare Atlanta, Sibley Heart Ctr, Atlanta, GA USA

[13] Emory Univ, Sch Med, Atlanta, GA USA

[14] Texas Childrens Hosp, Sect Crit Care, Houston, TX USA

[15] Texas Childrens Hosp, Sect Cardiol, Houston, TX USA

[16] Baylor Coll Med, Houston, TX USA

[17] Childrens Hosp Wisconsin, Milwaukee, WI USA

[18] Univ Florida, Congenital Heart Ctr, Dept Surg, Div Cardiothorac Surg, Gainesville, FL USA

[19] Univ Florida, Congenital Heart Ctr, Dept Pediat, Div Cardiothorac Surg, Gainesville, FL USA

[20] Duke Univ, Sch Med, Div Pediat Cardiol, Durham, NC USA

[21] Univ Southern Calif, Childrens Hosp Los Angeles, Dept Pediat, Div Cardiol,Keck Sch Med, Los Angeles, CA USA

[22] Univ Toronto, Hosp Sick Children, Labatt Family Heart Ctr, Dept Pediat, Toronto, ON, Canada

[23] Primary Childrens Med Ctr, Div Cardiol, Salt Lake City, UT USA

[24] Univ Utah, Sch Med, Salt Lake City, UT USA

[25] CS Mott Childrens Hosp, Div Pediat Cardiothorac Surg, Ann Arbor, MI USA

[26] Univ Michigan, Sch Med, Ann Arbor, MI USA

[27] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Heart Inst, Sch Med, Cincinnati, OH USA

[28] Univ Cincinnati, Sch Med, Dept Pediat, Cincinnati, OH USA

[29] Cincinnati Childrens Hosp Med Ctr, Div Cardiol, Cincinnati, OH USA

[30] Childrens Hosp Philadelphia, 3401 Civ Ctr Blvd, Philadelphia, PA 19104 USA

来源：

JACC-ADVANCES | 2022年 / 1卷 / 02期

关键词：

economic analysis; hypoplastic left heart syndrome; outcomes research; pediatrics; HYPOPLASTIC LEFT-HEART; ATRIAL SEPTAL-DEFECTS; RESOURCE UTILIZATION; NORWOOD OPERATION; RISK-FACTORS; INTERSTAGE MORTALITY; INPATIENT COSTS; BLALOCK-TAUSSIG; HYBRID APPROACH; SHUNT TYPE;

D O I：

10.1016/j.jacadv.2022.100029

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND In the SVR (Single Ventricle Reconstruction) Trial, 1-year survival in recipients of right ventricle to pulmonary artery shunts (RVPAS) was superior to that in those receiving modified Blalock-Taussig-Thomas shunts (MBTTS), but not in subsequent follow-up. Cost analysis is an expedient means of evaluating value and morbidity. OBJECTIVES The purpose of this study was to evaluate differences in cumulative hospital costs between RVPAS and MBTTS. METHODS Clinical data from SVR and costs from Pediatric Health Information Systems database were combined. Cumulative hospital costs and cost-per-day-alive were compared serially at 1, 3, and 5 years between RVPAS and MBTTS. Potential associations between patient-level factors and cost were explored with multivariable models. RESULTS In total, 303 participants (55% of the SVR cohort) from 9 of 15 sites were studied (48% MBTTS). Observed total costs at 1 year were lower for MBTTS ($701,260 +/- 442,081) than those for RVPAS ($804,062 +/- 615,068), a difference that was not statistically significant (P = 0.10). Total costs were also not significantly different at 3 and 5 years (P = 0.21 and 0.32). Similarly, cost-per-day-alive did not differ significantly for either group at 1, 3, and 5 years (all P > 0.05). In analyses of transplant-free survivors, total costs and cost-per-day-alive were higher for RVPAS at 1 year (P = 0.05 for both) but not at 3 and 5 years (P > 0.05 for all). In multivariable models, aortic atresia and prematurity were associated with increased cost-per-day-alive across follow-up (P < 0.05). CONCLUSIONS Total costs do not differ significantly between MBTTS and RVPAS. The magnitude of longitudinal costs underscores the importance of efforts to improve outcomes in this vulnerable population. (c) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

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