Disparities in Birth Defect Related Hospitalization Costs and Length of Stay in the US, 2019

Hospitalization costs for individuals with birth defects exceeded $22 billion in the US in 2019. Understanding hospitalization disparities is critical for resource allocation, and studies on this topic are limited.

In this cross-sectional study, we identified costs and length of stay from the 2019 National Inpatient Sample data, Healthcare Cost and Utilization Project. Disparities were assessed using age, race/ethnicity, regions, expected primary payer, median household income, rurality, and whether the hospitals were public or private.

Among 912,570 inpatients under 65 years old with birth defect diagnoses, those who were Black (8.3 days), resided in the South (7.6 days), and had Medicaid (8.3 days) as expected primary payer experienced longer average lengths of stay. Inpatients who were White ($10,287 million dollars), lived in the South ($7347 million dollars), and had Medicaid as the expected primary payer ($9760 million dollars) had higher total medical costs. Hispanic inpatients and those of other racial/ethnic groups ($26,145, $26,836), inpatients in the West ($29,244), as well as among those with "other" as the expected primary payer ($36,665) had higher average medical costs.

We observed disparities in birth-defect-related inpatients, with variations in medical costs and average length of stay. Health resources may be more effectively allocated to these groups.