Hospitalizations and associated costs in a population-based study of children with Down syndrome born in Florida
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Published on: August 11, 2015
April L Dawson1, Cynthia H Cassell, Matthew E Oster
1National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia.
Insights
Children with Down syndrome (DS) and co-occurring birth defects, especially severe congenital heart defects (CHDs), incur higher hospital costs. Resource use is significantly greater for non-isolated DS cases, particularly in infancy and early childhood.
Area of Science:
- Pediatric Health
- Genetics and Genomics
- Healthcare Management
Background:
- Down syndrome (DS) is frequently associated with congenital anomalies.
- Understanding hospital resource utilization in children with DS is crucial for healthcare planning.
- Congenital heart defects (CHDs) are common comorbidities in DS, impacting health outcomes.
Purpose of the Study:
- To analyze hospital resource usage in children with Down syndrome.
- To investigate the influence of age and co-occurring birth defects on healthcare utilization.
- To compare resource use between isolated DS and DS with various congenital anomalies, including CHDs.
Main Methods:
- Retrospective, population-based study of children with Down syndrome born between 1998-2007 in Florida.
- Linked Florida Birth Defects Registry (FBDR) data with hospital discharge records.
- Analyzed inpatient days and hospital costs, stratified by isolated DS, severe CHDs, nonsevere CHDs, and other major birth defects.
Main Results:
- Over 2500 children with DS experienced over 6800 inpatient admissions, with most in the first year of life.
- Children with severe CHDs incurred the highest inpatient costs from infancy through age 4.
- Non-isolated DS groups (with CHDs or other major defects) showed significantly higher hospital costs than isolated DS.
Conclusions:
- The presence of co-occurring anomalies significantly impacts hospital use and costs for children with Down syndrome.
- Children with Down syndrome and severe congenital heart defects demonstrate substantially greater hospital resource utilization.
- Healthcare resource allocation should consider the complex needs of children with Down syndrome and associated birth defects.
Background:
Our objective was to examine differences in hospital resource usage for children with Down syndrome by age and the presence of other birth defects, particularly severe and nonsevere congenital heart defects (CHDs).
Methods:
This was a retrospective, population-based, statewide study of children with Down syndrome born 1998 to 2007, identified by the Florida Birth Defects Registry (FBDR) and linked to hospital discharge records for 1 to 10 years after birth. To evaluate hospital resource usage, descriptive statistics on number of hospitalized days and hospital costs were calculated. Results were stratified by isolated Down syndrome (no other coded major birth defect); presence of severe and nonsevere CHDs; and presence of major FBDR-eligible birth defects without CHDs.
Results:
For 2552 children with Down syndrome, there were 6856 inpatient admissions, of which 68.9% occurred during the first year of life (infancy). Of the 2552 children, 31.7% (n = 808) had isolated Down syndrome, 24.0% (n = 612) had severe CHDs, 36.3% (n = 927) had nonsevere CHDs, and 8.0% (n = 205) had a major FBDR-eligible birth defect in the absence of CHD. Infants in all three nonisolated DS groups had significantly higher hospital costs compared with those with isolated Down syndrome. From infancy through age 4, children with severe CHDs had the highest inpatient costs compared with children in the other sub-groups.
Conclusion:
Results support findings that for children with Down syndrome the presence of other anomalies influences hospital use and costs, and children with severe CHDs have greater hospital resource usage than children with other CHDs or major birth defects without CHDs.
