Resource Use and Outcomes of Pediatric Congenital Heart Disease Admissions: 2003 to 2016

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Implantation of Total Artificial Heart in Congenital Heart Disease
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Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

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Jonathan B Edelson1,2,3, Joseph W Rossano1,2,3, Heather Griffis4

  • 1Division of Cardiology Cardiac Center, the Children's Hospital of PhiladelphiaUniversity of Pennsylvania Perelman School of Medicine Philadelphia PA.

Journal of the American Heart Association
|February 8, 2021
PubMed

Insights

Hospitalizations for children with congenital heart disease (CHD) increased, with higher costs and mortality. Despite improved survival rates for CHD patients, they represent a growing share of pediatric inpatient deaths, highlighting the need for better resource allocation.

Area of Science:

  • Pediatric Cardiology
  • Health Services Research
  • Public Health

Background:

  • Congenital heart disease (CHD) significantly impacts healthcare resource utilization.
  • Limited data exist on temporal trends in resource use and mortality for pediatric CHD admissions.
  • This study addresses the need for updated information on CHD hospitalization patterns.

Purpose of the Study:

  • To analyze trends in the frequency, medical complexity, and outcomes of pediatric hospital admissions for CHD from 2003 to 2016.
  • To compare resource utilization and mortality rates between CHD and non-CHD pediatric admissions.
  • To assess changes in healthcare charges and mortality rates over time for children with CHD.

Main Methods:

  • Utilized the Kids' Inpatient Database (KID), a nationally representative dataset.
  • Included inpatient admissions for patients under 18 years old with CHD between 2003 and 2016.
  • Analyzed admission frequency, patient demographics, comorbidities, healthcare charges, and mortality rates.

Main Results:

  • CHD admissions increased by 31.8% from 2003 to 2016, while overall pediatric admissions decreased by 13.4%.
  • CHD admissions were more likely to involve younger children (<1 year) and those with complex chronic conditions.
  • Adjusted median charges for CHD admissions increased significantly, while mortality rates decreased from 3.2% to 2.7% over the study period.
  • Despite decreased mortality, CHD admissions constituted an increasing proportion of all pediatric inpatient deaths (18.0% in 2003 to 24.5% in 2016).

Conclusions:

  • Children with CHD face significantly higher mortality risks and healthcare costs compared to their peers without CHD.
  • While survival rates for pediatric CHD admissions have improved, the overall burden on healthcare resources and mortality share has increased.
  • Optimizing resource allocation is crucial for improving outcomes in this high-risk pediatric population.

Keywords:
congenital heart diseasemortalityresource utilization

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