Pediatric Cardiology

, Volume 38, Issue 5, pp 1065–1070 | Cite as

Resource Utilization Associated with Extracardiac Co-morbid Conditions Following Congenital Heart Surgery in Infancy

  • Krista E. Tuomela
  • John B. Gordon
  • Laura D. Cassidy
  • Sarah Johaningsmeir
  • Nancy S. Ghanayem
Original Article

Abstract

Congenital heart disease (CHD) is often associated with chronic extracardiac co-morbid conditions (ECC). The presence of ECC has been associated with greater resource utilization during the operative period; however, the impact beyond hospital discharge has not been described. This study sought to understand the scope of chronic ECC in infants with CHD as well as to describe the impact of ECC on resource utilization after discharge from the index cardiac procedure. IRB approved this retrospective study of infants <1 year who had cardiac surgery from 2006 and 2011. Demographics, diagnoses, procedures, STAT score, and ECC were extracted from the medical record. Administrative data provided frequency of clinic and emergency room visits, admissions, cumulative hospital days, and hospital charges for 2 years after discharge from the index procedure. Data were compared using Mann–Whitney Rank Sum Test with p < 0.05 considered significant. ECC occurred in 55% (481/876) of infants. Median STAT score was higher in the group with ECC (3 vs. 2, p < 0.001). Resource utilization after discharge from the index procedure as defined by median hospital charges (78 vs. 10 K, p < 0.001 and unplanned hospital days 4 vs. 0, p < 0.001) was higher in those with ECC, and increased with the greater number of ECC, even after accounting for surgical complexity. STAT score and the presence of multiple ECC were associated with higher resource utilization following the index cardiac surgical procedure. These data may be helpful in deciding which children might benefit from a cardiac complex care program that partners families and providers to improve health and decrease healthcare costs.

Keywords

Children with medical complexity Congenital heart disease Multiple chronic complex conditions 

Notes

Acknowledgements

This research was supported by funding from the Jack Hartmann Open and Medical Student Summer Research Program at the Medical College of Wisconsin. The authors would like to thank Patricia Stachowiak and Maryanne Kessel from Children’s Hospital of Wisconsin, Milwaukee, WI for their assistance in obtaining administrative data.

Compliance with Ethical Standards

Conflicts of interest

The author(s) declare that they have no competing interests.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Krista E. Tuomela
    • 4
  • John B. Gordon
    • 1
    • 4
  • Laura D. Cassidy
    • 3
    • 4
  • Sarah Johaningsmeir
    • 1
    • 4
  • Nancy S. Ghanayem
    • 2
    • 4
    • 5
  1. 1.Divisions of Special Needs, Department of PediatricsPediatric Division of Special NeedsMilwaukeeUSA
  2. 2.Critical Care, Department of PediatricsPediatric Division of Special NeedsMilwaukeeUSA
  3. 3.Institute for Health and SocietyMilwaukeeUSA
  4. 4.Medical College of WisconsinMilwaukeeUSA
  5. 5.Department of Pediatrics, Division of Critical CareBaylor College of Medicine and Texas Children’s HospitalHoustonUSA

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