Inpatient admissions and costs for adolescents and young adults with congenital heart defects in New York, 2009–2013

• Published in: Birth defects research 2021-01, Vol.113 (2), p.173-188
• Main Authors: Hsu, Wan‐Hsiang, Sommerhalter, Kristin M., McGarry, Claire E., Farr, Sherry L., Downing, Karrie F., Lui, George K., Zaidi, Ali N., Hsu, Daphne T., Van Zutphen, Alissa R.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; adolescents and young adults; Adult; Adults; Child; congenital heart defects; Costs; Defects; Female; Health care; Heart; Heart Defects, Congenital - epidemiology; Heart Defects, Congenital - therapy; hospital utilization; Hospitalization; hospitalizations; Humans; inpatient cost; Inpatients; Length of Stay; New York - epidemiology; Teenagers; Utilization; Young Adult; Young adults
• ISSN: 2472-1727; 2472-1727
• DOI: 10.1002/bdr2.1809

Objectives Most individuals born with congenital heart defects (CHDs) survive to adulthood, but healthcare utilization patterns for adolescents and adults with CHDs have not been well described. We sought to characterize the healthcare utilization patterns and associated costs for adolescents and young adults with CHDs. Methods We examined 2009–2013 New York State inpatient admissions of individuals ages 11–30 years with ≥1 CHD diagnosis codes recorded during any admission. We conducted multivariate linear regression using generalized estimating equations to examine associations between inpatient costs and sociodemographic and clinical variables. Results We identified 5,100 unique individuals with 9,593 corresponding hospitalizations over the study period. Median inpatient cost and length of stay (LOS) were $10,720 and 3.0 days per admission, respectively; 55.1% were emergency admissions. Admission volume increased 48.7% from 2009 (1,538 admissions) to 2013 (2,287 admissions), while total inpatient costs increased 91.8% from 2009 ($27.2 million) to 2013 ($52.2 million). Inpatient admissions and costs rose more sharply over the study period for those with nonsevere CHDs compared to severe CHDs. Characteristics associated with higher costs were longer LOS, severe CHD, cardiac/vascular hospitalization classification, surgical procedures, greater severity of illness, and admission in New York City. Conclusion This study provides an informative baseline of health care utilization patterns and associated costs among adolescents and young adults with CHDs in New York State. Structured transition programs may aid in keeping this population in appropriate cardiac care as they move to adulthood.