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Prevalence and Cost of Managing Paediatric Cardiac Disease in Queensland
Geoffrey A Strange1, Sundar Veerappan2, Nelson Alphonso2
1School of Medicine, University of Notre Dame, Freemantle, WA, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Insights
Congenital heart disease (CHD) affects many children in Queensland, with significant healthcare costs. Ventricular septal defect (VSD) is the most common condition and highest cost driver.
Area of Science:
- Pediatric Cardiology
- Public Health
- Health Economics
Background:
- Limited contemporary data exists on the prevalence and healthcare costs of common pediatric cardiac conditions in Australia.
- Congenital heart disease (CHD) is a significant concern within this data gap.
Purpose of the Study:
- To determine the prevalence and direct healthcare expenditure of the 10 most common cardiac conditions in Queensland children.
- To identify the primary drivers of healthcare costs associated with pediatric cardiac conditions.
Main Methods:
- Retrospective analysis of electronic health records for 2,519 pediatric patients managed by Queensland Paediatric Cardiac Service (2014-2015).
- Inclusion of conditions like ventricular septal defect (VSD), pulmonary stenosis, and others.
- Extraction of demographic data, clinic visits, investigations, and interventions to calculate population estimates and costs.
Main Results:
- 2,519 patients managed for 10 common cardiac conditions, with 787 prevalent cases under 5 years.
- Total annual healthcare costs estimated at $13.6 million, including $2.25 million for investigations and $13.6 million for procedures.
- Ventricular septal defect (VSD) was the most frequent condition (38.6%) and the largest contributor to costs ($5.1 million/annum).
Conclusions:
- Pilot data reveal a substantial patient population and healthcare burden from congenital heart disease (CHD) in Queensland.
- Urgent need for initiatives to comprehensively quantify the individual and health system impact of pediatric cardiac conditions.
Background:
There is a paucity of contemporary information regarding the prevalence and related health care expenditure of the most common cardiac conditions in Australian children, including congenital heart disease (CHD).
Methods:
The 10 most common cardiac conditions managed by Queensland Paediatric Cardiac Service during 2014-2015 were identified from an electronic database: ventricular septal defect (VSD), pulmonary stenosis, aortic stenosis, tetralogy of Fallot, atrioventricular septal defect, transposition, Ebstein's anomaly, long QT syndrome, dilated cardiomyopathy, and rheumatic carditis. Demographic data, clinic attendance, investigational procedures, and therapeutic interventions were extracted from the electronic health records to derive indicative population estimates and direct health care expenditure relating to CHD.
Results:
A total of 2,519 patients diagnosed with the 10 target conditions were being actively managed, including 456 (18.1%) new-born and 787 prevalent cases (2.5/1,000 population) aged <5 years. A total of 12,180 (4.8/case) investigations were performed (6,169 echocardiographic and 279 cardiac catheterisation procedures) costing $2.25 million/annum. A further 5,326 clinic visits (2.1/case, 22% regional) were conducted at a cost of $550,000/annum. A combined total of 804 catheter-based interventions and surgical procedures were performed in 300 cases (11.9%) at a cost of $13.6 million/annum. VSD (38.6% of cases) was the single greatest contributor ($5.1 million/annum) to total combined direct health care costs of $13.6 million/annum for the 2,519 patients.
Conclusions:
These pilot data indicate a significant patient population and health care burden imposed by CHD in Queensland. Future initiatives to better quantify this burden, from an individual to health system perspective, are urgently needed.
