Hospital Inpatient Costs for Single-ventricle Patients Surviving the Fontan Procedure

• Published in: The American journal of cardiology 2017-08, Vol.120 (3), p.467-472
• Main Authors: Huang, Li, PhD, Schilling, Chris, MSc, Dalziel, Kim M., PhD, Xie, Siyu, MPH, Celermajer, David S., MBBS, PhD, DSc, McNeil, John J., MBBS, PhD, Winlaw, David, MBBS(Hons), MD, Hornung, Tim S., MB, BChir, Radford, Dorothy J., MBBS, MD, Grigg, Leeanne E., MBBS, Bullock, Andrew, MBBS, Wheaton, Gavin R., MBBS, Justo, Robert N., MBBS, Blake, Jayne, Bishop, Rachel, BAppSc, Du Plessis, Karin, PhD, d’Udekem, Yves, MD, PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Age; Australia - epidemiology; Birth; Cardiovascular; Cardiovascular disease; Child; Child, Preschool; Childbirth & labor; Children & youth; Confidence intervals; Congenital diseases; Coronary artery disease; Costs; Demographics; Diagnosis related groups; DRGs; Female; Fontan Procedure - economics; Heart; Heart Defects, Congenital - economics; Heart Defects, Congenital - mortality; Heart Defects, Congenital - surgery; Heart diseases; Heart surgery; Heart Ventricles - abnormalities; Heart Ventricles - surgery; Hospital Costs; Hospitals; Humans; Infant; Infant, Newborn; Inpatients; Male; Patients; Pediatrics; Registries; Retrospective Studies; Surgery; Survival Rate - trends; Trends; Tricuspid atresia; Ventricle
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2017.04.049

Abstract We estimated the inpatient resource use for a Fontan patient from birth to adulthood and explored factors that might induce cost differences (2014 US dollar). Inpatient costing records from four hospitals with greatest numbers of Fontan patients in Australia and New Zealand were linked with the Fontan registry database. Inpatient records between July 1995 and September 2014 for 420 Fontan patients were linked, and the most frequent primary diagnoses were hypoplastic left heart syndrome (HLHS) (20.7%), tricuspid atresia (19.7%), and double inlet left ventricle (17.1%). The mean hospital cost for a Fontan patient from birth to 18 years of age was estimated to be $390,601 (95% confidence interval [CI] $264,703 to $516,499), corresponding to 164 (95% CI 98 to 231) inpatient days. The cost incurred from birth through to Fontan completion (the staged procedures period) was $219,482 (95% CI $202,410 to $236,553) and the cost thereafter over 15 years was $146,820 (95% CI $44,409 to $249,231), corresponding to 82 (95% CI 72 to 92) and 65 (95% CI 18 to 112) inpatient days respectively. Costs were higher in male and HLHS patients in the staged procedures period (P