Predicting Economic and Medical Outcomes Based on Risk Adjustment for Congenital Heart Surgery Classification of Pediatric Cardiovascular Surgical Admissions

The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification is an established method for predicting mortality for congenital heart disease surgery. It is unknown if this extends to the cost of hospitalization or if differences in economic and medical outcomes exist in certain subpopula...

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Bibliographic Details
Published in:The American journal of cardiology 2014-12, Vol.114 (11), p.1740-1744
Main Authors: Raucci, Frank J., MD, PhD, Hoke, Tracey R., MD, MSc, Gutgesell, Howard P., MD
Format: Article
Language:English
Subjects:
Adolescent
African Americans - statistics & numerical data
Cardiac Surgical Procedures - economics
Cardiac Surgical Procedures - mortality
Cardiovascular
Child
Child, Preschool
Classification
Cohort Studies
Confidence intervals
Costs
Critical Care - economics
Critical Care - statistics & numerical data
Ethnicity
European Continental Ancestry Group - statistics & numerical data
Female
Gender
Heart Defects, Congenital - economics
Heart Defects, Congenital - mortality
Heart Defects, Congenital - surgery
Heart surgery
Hispanic Americans - statistics & numerical data
Hispanic people
Hospital Costs - statistics & numerical data
Hospital Mortality
Hospitalization
Hospitalization - economics
Hospitals
Humans
Infant
Infant, Newborn
Intensive Care Units
Length of Stay - economics
Length of Stay - statistics & numerical data
Male
Mortality
Race
Retrospective Studies
Risk Adjustment
Risk Assessment
Treatment Outcome
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Summary:The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification is an established method for predicting mortality for congenital heart disease surgery. It is unknown if this extends to the cost of hospitalization or if differences in economic and medical outcomes exist in certain subpopulations. Using data obtained from the University HealthSystem Consortium, we examined inpatient resource use by patients with International Classification of Diseases, Ninth Revision, procedure codes representative of RACHS-1 classifications 1 through 5 and 6 from 2006 to 2012. A total of 15,453 pediatric congenital heart disease surgical admissions were analyzed, with overall mortality of 4.5% (n = 689). As RACHS-1 classification increased, the total cost of hospitalization, hospital charges, total length of stay, length of intensive care unit stay, and mortality increased. Even when controlled for RACHS-1 classification, black patients (n = 2034) had higher total costs ($96,884 ± $3,392, p = 0.003), higher charges ($318,313 ± $12,018, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2014.09.006