Pediatric Cardiology

, Volume 38, Issue 7, pp 1365–1369 | Cite as

Lower Hospital Charges and Societal Costs for Catheter Device Closure of Atrial Septal Defects

Original Article

Abstract

Atrial septal defects (ASD) are among the most common congenital heart defects. As more ASDs are corrected by interventional catheterization instead of surgery, it is critical to understand the associated clinical and societal costs. The goal of this study was to use a national U.S. database to describe hospital charges and societal costs for surgical and catheter-based (ASD) closure. Retrospective review of hospital discharge data from the Kids’ Inpatient Database from January 2010 to December 2012. The database was queried for admissions for <21 years old with ICD-9 procedure codes for surgical (35.51 or 35.61) or catheter (35.52) ASD closure; those with other cardiac conditions and/or additional cardiac procedures were excluded. Age, length of stay (LOS), and hospital charges and lost parental wages (societal costs) were compared between groups using t test or Mann–Whitney U test, as appropriate. Four hundred and eighty-six surgical and 305 catheter ASD closures were identified. LOS, hospital charges, and total societal costs were higher in surgical ASD compared to catheter ASD admissions (3.6 vs. 1.3 days, p < 0.001, $87,465 vs. $64,109, p < 0.001, and $90,000 vs. $64,966, p < 0.001, respectively). In this review of a large national inpatient database, we found that hospital and societal costs for surgical ASD closure are significantly higher than catheter ASD closure in the United States in the current era. Factors that likely contribute to this include longer LOS and longer post-operative recovery. Using “real-world” data, this study demonstrates a substantial cost advantage for catheter ASD closure compared to surgical.

Keywords

Surgery Congenital heart disease Closure ASD/PDA/PFO Economics/cost-effectiveness Pediatric intervention 

Notes

Acknowledgements

The authors would like to acknowledge all of the HCUP Data Partners that contribute to HCUP. The complete list can be found at http://www.hcup-us.ahrq.gov/db/hcupdatapartners.jsp.

Funding

There are no sources of funding to declare.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

The need for informed consent was waived by the University of Arizona Institutional Review Board.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.College of MedicineUniversity of ArizonaTucsonUSA
  2. 2.Department of Pediatrics (Cardiology)University of ArizonaTucsonUSA

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