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The Financial Burden of Surgery for Congenital Malformations-The Austrian Perspective
Paolo Gasparella1,2, Georg Singer1,2, Bernhard Kienesberger1,2
1Department of Paediatric and Adolescent Surgery, Medical University of Graz, 8036 Graz, Austria.
Insights
Congenital surgical malformations in newborns significantly increase healthcare costs compared to non-surgical birth defects. A national registry could improve resource allocation and outcomes for affected children.
Area of Science:
- Pediatric Surgery
- Health Economics
- Public Health
Background:
- Neonatal surgical malformations incur higher healthcare costs than non-surgical birth defects.
- Timely postnatal surgery is critical for specific congenital malformations.
Purpose of the Study:
- To analyze the financial burden of five specific congenital malformations requiring surgery on the Austrian healthcare system.
- To compare the costs of these malformations with other hospitalizations.
Main Methods:
- Retrospective review of the Austrian National Public Health Institute database (2002-2014).
- Analysis of Diagnosis-Related Group (DRG) points for hospital admissions with esophageal atresia, duodenal atresia, congenital diaphragmatic hernia, gastroschisis, and omphalocele.
- Comparison of DRG points for these malformations against all other hospitalizations.
Main Results:
- 1664 admissions for the selected malformations were identified out of 3,518,625 total hospitalizations.
- The mean cost (DRG points) for these surgical malformations was 26,588, significantly higher than the mean DRG of 2194 for other hospitalizations (p < 0.05).
Conclusions:
- Congenital malformations requiring timely postnatal surgery represent a substantial financial burden on the healthcare system.
- Establishing a national registry is recommended for improved resource allocation, child outcomes, and cost optimization.
Abstract:
Neonatal "surgical" malformations are associated with higher costs than major "non-surgical" birth defects. We aimed to analyze the financial burden on the Austrian health system of five congenital malformations requiring timely postnatal surgery. The database of the Austrian National Public Health Institute for the period from 2002 to 2014 was reviewed. Diagnosis-related group (DRG) points assigned to hospital admissions containing five congenital malformations coded as principal diagnosis (esophageal atresia, duodenal atresia, congenital diaphragmatic hernia, gastroschisis, and omphalocele) were collected and compared to all hospitalizations for other reasons. Out of 3,518,625 total hospitalizations, there were 1664 admissions of patients with the selected malformations. The annual mean number was 128 (SD 17, range 110-175). The mean cost of the congenital malformations per hospital admission expressed in DRG points was 26,588 (range 0-465,772, SD 40,702) and was significantly higher compared to the other hospitalizations (n = 3,516,961; mean DRG 2194, range 0-834,997; SD 6161; p < 0.05). Surgical conditions requiring timely postnatal surgery place a significant financial burden on the healthcare system. The creation of a dedicated national register could allow for better planning of resource allocation, for improving the outcome of affected children, and for optimizing costs.
