Treatment Costs Vary for U.S. Children Born With Heart Defects

FRIDAY Feb. 28, 2014, 2014 -- The cost of treatment for children born with heart defects varies widely across the United States, according to new research. And higher costs may not mean better care.

The study found that surgical procedures to repair these defects in one hospital could be up to nine times more costly in another U.S. hospital. The authors say that treatment practices for these birth defects, which affect one of every 100 births, must be standardized to reduce costs and improve quality of care.

"Before we conducted this study, there was limited information on the costs associated with caring for these children, even though this is one of the most common and expensive conditions treated across children's hospitals," lead author Dr. Sara Pasquali, an associate professor of pediatrics at the University of Michigan Medical School and C.S. Mott Children's Hospital Congenital Heart Center, said in a university news release.

The study, published Feb. 24 in Pediatrics, involved more than 12,000 patients treated at 27 children's hospitals in the United States. The costs for just about all procedures performed on children born with heart defects varied from hospital to hospital. This was true even after differences among regions and patient characteristics were taken into account, the researchers noted.

In looking more closely at why costs varied so, the researchers found the number of procedures performed in a hospital plays a role. Facilities that treat more of these birth defects had much lower costs for even the most complex operations.

Patients treated in the highest-cost hospitals also tended to remain in the hospital longer after their operations.

For one specific birth defect known as "hypoplastic left heart syndrome," hospitals with the highest costs of care had double the rate of complications following surgery than hospitals with the lowest costs of care.

"In this era of rising health care costs, there is an increasing need to provide care more efficiently and reduce costs," Pasquali said. "The cost variations we found in this study suggest there is ample room for improvement, and also suggest a link between high-quality care and lower cost. For example, initiatives aimed at reducing length of stay and complication rates have the potential to both improve quality and also lower costs."

Previous research showed that standardizing care for a surgical complication in infants led to earlier diagnosis of the problem, improved treatment and shorter hospital stays, according to the news release.

"More research is needed in order to better understand how hospitals may achieve improvements in this area," Pasquali added. "Data from our institution and others suggest that standardization of practice may be important. Better ways to share these best practices among hospitals is needed. We hope that this research is a catalyst to engage hospitals in working together to both improve quality and lower costs of care for these patients."

More information

Visit the American Heart Association to learn more about congenital heart defects.

Posted: February 2014


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