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Variation in congenital heart surgery costs across hospitals.

Publication ,  Journal Article
Pasquali, SK; Jacobs, ML; He, X; Shah, SS; Peterson, ED; Hall, M; Gaynor, JW; Hill, KD; Mayer, JE; Jacobs, JP; Li, JS
Published in: Pediatrics
March 2014

BACKGROUND: A better understanding of costs associated with common and resource-intense conditions such as congenital heart disease has become increasingly important as children's hospitals face growing pressure to both improve quality and reduce costs. We linked clinical information from a large registry with resource utilization data from an administrative data set to describe costs for common congenital cardiac operations and assess variation across hospitals. METHODS: Using linked data from The Society of Thoracic Surgeons and Pediatric Health Information Systems Databases (2006-2010), estimated costs/case for 9 operations of varying complexity were calculated. Between-hospital variation in cost and associated factors were assessed by using Bayesian methods, adjusting for important patient characteristics. RESULTS: Of 12,718 operations (27 hospitals) included, median cost/case increased with operation complexity (atrial septal defect repair, [$25,499] to Norwood operation, [$165,168]). Significant between-hospital variation (up to ninefold) in adjusted cost was observed across operations. Differences in length of stay (LOS) and complication rates explained an average of 28% of between-hospital cost variation. For the Norwood operation, high versus low cost hospitals had an average LOS of 50.8 vs. 31.8 days and a major complication rate of 50% vs. 25.3%. High volume hospitals had lower costs for the most complex operations. CONCLUSIONS: This study establishes benchmarks for hospital costs for common congenital heart operations and demonstrates wide variability across hospitals related in part to differences in LOS and complication rates. These data may be useful in designing initiatives aimed at both improving quality of care and reducing cost.

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Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

March 2014

Volume

133

Issue

3

Start / End Page

e553 / e560

Location

United States

Related Subject Headings

  • Registries
  • Pediatrics
  • Male
  • Infant
  • Humans
  • Hospitals, Pediatric
  • Hospital Costs
  • Heart Defects, Congenital
  • Female
  • Databases, Factual
 

Citation

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Chicago
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Pasquali, S. K., Jacobs, M. L., He, X., Shah, S. S., Peterson, E. D., Hall, M., … Li, J. S. (2014). Variation in congenital heart surgery costs across hospitals. Pediatrics, 133(3), e553–e560. https://doi.org/10.1542/peds.2013-2870
Pasquali, Sara K., Marshall L. Jacobs, Xia He, Samir S. Shah, Eric D. Peterson, Matthew Hall, J William Gaynor, et al. “Variation in congenital heart surgery costs across hospitals.Pediatrics 133, no. 3 (March 2014): e553–60. https://doi.org/10.1542/peds.2013-2870.
Pasquali SK, Jacobs ML, He X, Shah SS, Peterson ED, Hall M, et al. Variation in congenital heart surgery costs across hospitals. Pediatrics. 2014 Mar;133(3):e553–60.
Pasquali, Sara K., et al. “Variation in congenital heart surgery costs across hospitals.Pediatrics, vol. 133, no. 3, Mar. 2014, pp. e553–60. Pubmed, doi:10.1542/peds.2013-2870.
Pasquali SK, Jacobs ML, He X, Shah SS, Peterson ED, Hall M, Gaynor JW, Hill KD, Mayer JE, Jacobs JP, Li JS. Variation in congenital heart surgery costs across hospitals. Pediatrics. 2014 Mar;133(3):e553–e560.

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

March 2014

Volume

133

Issue

3

Start / End Page

e553 / e560

Location

United States

Related Subject Headings

  • Registries
  • Pediatrics
  • Male
  • Infant
  • Humans
  • Hospitals, Pediatric
  • Hospital Costs
  • Heart Defects, Congenital
  • Female
  • Databases, Factual