Inpatient Hospitalization Charges for Children With Birth Defects in Texas, 2021-2023

Children with birth defects often require complex medical care, contributing to increased healthcare costs. Understanding the economic burden of birth defects is important for resource planning, but recent Texas-specific data are lacking.

A retrospective data analysis was conducted using the Texas Hospital Inpatient Discharge Public Use Data File (PUDF) for all pediatric discharges (ages 0-17 years) documented between 2021 and 2023. We identified hospitalizations with birth defects based on the presence of an ICD-10 code (Q00-Q99) in any of the 26 diagnosis code fields. Median inflation-adjusted hospitalization charges were calculated for hospitalizations with and without birth defects and were then stratified by characteristics of interest. Median charges were compared using the Wilcoxon-rank sum test. Among hospitalizations of children with a birth defect in the principal diagnosis code field, charges were examined by birth defect phenotype. A sub-analysis assessed charges for hospitalizations that occurred primarily in the Intensive Care Unit (ICU).

In Texas, 12.5% of all pediatric hospitalizations were for children with a birth defect. Aggregate total charges for these hospitalizations exceeded $26 billion and comprised 34.9% of all pediatric hospitalization charges. Hospitalizations for children with a birth defect had significantly higher median charges ($12,876 vs. $7,813) compared to hospitalizations for children without birth defects (p < 0.001). Higher charges were observed for hospitalizations among several subgroups (e.g., ICU hospitalizations).

Inpatient hospitalization charges for children with birth defects had a disproportionately high impact on hospitalization charges in Texas.