Costs of prenatal detection of congenital heart disease

Area of Science:

• Medical Economics
• Neonatal Care
• Diagnostic Imaging

Background:

• Limited data exists on transportation expenses linked to missed prenatal diagnosis of congenital heart disease (CHD).
• Postnatal diagnosis of major CHD incurs significant emergency transportation costs.
• Cost-benefit analysis is needed for improved prenatal detection strategies.

Purpose of the Study:

• To analyze emergency transportation costs for infants with CHD diagnosed postnatally.
• To conduct a cost-benefit analysis of enhanced ultrasound technician training for improved prenatal CHD detection.
• To evaluate the financial implications of increasing prenatal detection rates.

Main Methods:

• Calculated 1-year emergency transportation costs for prenatally and postnatally diagnosed CHD infants in Northern California and North Western Nevada.
• Compared costs between the two diagnostic timing groups.
• Modeled cost savings based on potential improvements in prenatal detection rates following technician training.

Main Results:

• The prenatal detection rate in the cohort was 30.6%.
• Infants diagnosed postnatally were 16.5 times more likely to require emergency transport (p <0.001).
• Total emergency transportation costs reached $542,143; mean costs were $389.00 for prenatal vs. $5,143.51 for postnatal diagnosis (p <0.001).

Conclusions:

• Postnatal diagnosis of CHD leads to significantly higher emergency transportation costs.
• A 1-day training for ultrasound technicians could recoup costs within 1 year if detection rates increase by 2.4%.
• Increasing prenatal detection to 50% could yield $6,543,476 in savings within 5 years.