Related Experiment Video
Updated: May 2, 2026
Creation of Patient-Specific Silicone Cardiac Models with Applications in Pre-surgical Plans and Hands-on Training
Published on: February 10, 2022
Variation in congenital heart surgery costs across hospitals
Sara K Pasquali1, Marshall L Jacobs, Xia He
1Department of Pediatrics and Communicable Diseases, University of Michigan C.S. Mott Children's Hospital, Ann Arbor, Michigan;
Insights
Hospital costs for congenital heart surgery vary widely, with complexity, length of stay, and complication rates driving differences. High-volume centers show lower costs for complex procedures.
Area of Science:
- Pediatric Cardiac Surgery
- Health Economics
- Healthcare Quality Improvement
Background:
- Rising pressure on children's hospitals to enhance quality and reduce costs.
- Need for better understanding of costs for resource-intense conditions like congenital heart disease.
Purpose of the Study:
- Describe costs for common congenital cardiac operations.
- Assess hospital-level cost variation for these procedures.
Main Methods:
- Linked clinical registry data with administrative utilization data.
- Calculated costs per case for 9 operations of varying complexity (2006-2010).
- Used Bayesian methods to assess between-hospital cost variation, adjusting for patient factors.
Main Results:
- Median cost per case increased with operation complexity, from $25,499 (atrial septal defect repair) to $165,168 (Norwood operation).
- Observed significant between-hospital cost variation (up to ninefold) after adjustment.
- Length of stay and complication rates explained 28% of cost variation; complex operations showed higher LOS and complication rates in high-cost hospitals.
- High-volume hospitals demonstrated lower costs for the most complex operations.
Conclusions:
- Established benchmarks for hospital costs in congenital heart operations.
- Demonstrated wide hospital-level variability in costs, partly due to length of stay and complication rates.
- Findings can inform initiatives to improve care quality and reduce costs in pediatric cardiac surgery.
Background:
A better understanding of costs associated with common and resource-intense conditions such as congenital heart disease has become increasingly important as children's hospitals face growing pressure to both improve quality and reduce costs. We linked clinical information from a large registry with resource utilization data from an administrative data set to describe costs for common congenital cardiac operations and assess variation across hospitals.
Methods:
Using linked data from The Society of Thoracic Surgeons and Pediatric Health Information Systems Databases (2006-2010), estimated costs/case for 9 operations of varying complexity were calculated. Between-hospital variation in cost and associated factors were assessed by using Bayesian methods, adjusting for important patient characteristics.
Results:
Of 12,718 operations (27 hospitals) included, median cost/case increased with operation complexity (atrial septal defect repair, [$25,499] to Norwood operation, [$165,168]). Significant between-hospital variation (up to ninefold) in adjusted cost was observed across operations. Differences in length of stay (LOS) and complication rates explained an average of 28% of between-hospital cost variation. For the Norwood operation, high versus low cost hospitals had an average LOS of 50.8 vs. 31.8 days and a major complication rate of 50% vs. 25.3%. High volume hospitals had lower costs for the most complex operations.
Conclusions:
This study establishes benchmarks for hospital costs for common congenital heart operations and demonstrates wide variability across hospitals related in part to differences in LOS and complication rates. These data may be useful in designing initiatives aimed at both improving quality of care and reducing cost.
