Increasing surgical healthcare utilization for infants with congenital anomalies in Texas
Bea B Jeon1,2, Sarah Peiffer1,2, Shannon M Larabee1,2
1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States.
Insights
Infants with congenital anomalies (CAs) requiring surgery incurred $4.8 billion in Texas hospital charges in 2021. The financial burden increases with the number of organ systems affected by the congenital anomaly.
Area of Science:
- Medical Economics
- Pediatric Surgery
- Public Health
Background:
- Congenital anomalies (CAs) affect 3% of live births, contributing significantly to healthcare costs.
- While multidisciplinary care and surgical interventions are common for CAs, the total financial impact on infants needing surgery remains largely uncharacterized.
Purpose of the Study:
- To evaluate and characterize the healthcare charges associated with infants diagnosed with congenital anomalies requiring surgical intervention in Texas.
Main Methods:
- A retrospective database study was conducted using the Texas Inpatient Public Use Data File (2021).
- Infant admissions (<365 days) with congenital anomalies and surgical needs were identified using ICD-10 codes.
- Descriptive statistics were employed to analyze hospital charges and admission data.
Main Results:
- Congenital anomaly (CA) surgical admissions accounted for $4.8 billion (73.4%) of total inpatient surgical charges, despite representing a smaller proportion of overall admissions.
- The median charge per CA surgical admission significantly increased with the number of affected organ systems: $1,296 (1 CA), $4,517 (2 CA), $20,272 (3 CA), and $25,313 (4+ CA).
- A higher number of involved organ systems correlated with an increased proportion of admissions requiring surgery.
Conclusions:
- Surgical care for infants with congenital anomalies represents a substantial financial burden on the healthcare system, accounting for a disproportionately high percentage of inpatient surgical charges.
- The complexity and cost of care escalate with the number of organ systems involved in congenital anomalies.
- These findings underscore the significant economic impact of congenital anomalies requiring surgical intervention in infants.
Introduction:
Congenital anomalies (CAs) impact 3% of live births and account for disproportionately high healthcare costs. While many CAs require multidisciplinary care and surgical intervention, the overall financial impact of infants diagnosed with CA with surgical needs is unknown. We aim to evaluate and characterize the charges of care in infants with CA and surgical needs in Texas.
Methods:
A database study using the Texas Inpatient Public Use Data File was performed to query infants (<365 days) statewide from 1/2021 to 12/2021 for admissions with CA and involved organ system by ICD-10 codes. Encounters transferred to an outside hospital were excluded to avoid systematic double-counting. Descriptive statistics were performed.
Results:
Of 376,215 total admissions, 81,666 had surgical needs with OR charges. While non-CA represent the majority of surgical admissions (63,895/81,666; 78.24%), CA-surgical admissions represent 73.3% ($4.766/$6.496 billion) surgical admissions charges. Of CA-surgical admissions, 78.9% were single organ-system (1CA) with 14.5% with two organ-systems (2CA), 4.0% with three organ-system (3CA) and 2.6% with 4 + organ-systems (4 + CA). The proportion of admissions with surgical needs increases with the number of CA organ-systems involved. The median charge per CA-surgical admission was $1,296 for1CA, $4,517 for 2CA, $20,272 for 3 CA, and $25,313 for 4 + CA compared to the $797 for non-CA surgical admissions. Surgical admission charges increase with the number of CA organ-systems involved.
Conclusions:
Surgical care of CA in infants is associated with significant healthcare utilization, accounting for $4.8 billion (73.4%) of all inpatient charges in 2021 despite representing a minority of admissions. Increasing number of CA organ-systems involved is associated with an increased proportion of patients with surgical admissions and increased median charge of admission.
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