Related Experiment Videos
Cost per anomaly: what does a diaphragmatic hernia cost?
A P Metkus1, L Esserman, A Sola
1Department of Surgery, University of California, San Francisco 94143-0570, USA.
Insights
The initial hospitalization for congenital diaphragmatic hernia (CDH) costs an average of $137,000. Extracorporeal membrane oxygenation (ECMO) significantly increases costs for treating this leading cause of infant mortality.
Area of Science:
- Medical Economics
- Pediatric Surgery
- Neonatal Care
Background:
- Birth defects are the leading cause of infant mortality in the U.S., surpassing prematurity.
- Congenital diaphragmatic hernia (CDH) significantly contributes to infant morbidity and mortality.
- Estimates of the costs associated with individual birth defects are scarce.
Purpose of the Study:
- To determine the initial hospitalization cost for infants diagnosed with congenital diaphragmatic hernia (CDH).
- To analyze the financial impact of extracorporeal membrane oxygenation (ECMO) on CDH treatment costs.
- To provide data for future cost comparisons and evaluation of new therapeutic strategies for CDH.
Main Methods:
- Analysis of hospital bills and professional fees for 35 infants undergoing postnatal CDH repair.
- Data collected from a single institution between January 1990 and December 1993.
- Comparison of costs between patients treated with and without ECMO.
Main Results:
- The average cost of initial hospitalization for CDH was $137,000 per patient.
- ECMO treatment dramatically increased the overall cost.
- The cost per survivor was $98,000 without ECMO and $365,000 with ECMO.
- The estimated annual cost of CDH in the U.S. exceeds $230 million.
Conclusions:
- CDH treatment incurs substantial healthcare costs, particularly when ECMO is required.
- The findings provide a baseline for cost-effectiveness analysis of CDH interventions.
- Strategies for cost reduction in CDH management should be explored.
Abstract:
The cost of medical care in the United States is under close scrutiny. Birth defects have surpassed prematurity as the leading cause of infant mortality in the United States and contribute significantly to infant morbidity. Few estimates have been made of the costs of individual birth defects. The authors sought to determine the cost of initial hospitalization for an infant with a congenital diaphragmatic hernia (CDH). They analyzed hospital bills and professional fees from all 35 cases of infants who underwent postnatal CDH repair at their institution between January 1990 and December 1993. The cost averaged $137,000 per patient, and ECMO dramatically increased the cost. The cost per survivor was $98,000 in the non-ECMO group and $365,000 in the ECMO group. The estimated cost of CDH per year in the United States is more than $230 million. This study suggests several strategies for cost reduction, provides data for future cost comparisons, and serves as a cost comparison for evaluating new therapeutic strategies for CDH.