title: Cardiac care for infants. Determinants of hospital charges for acute care.
abstract: We analyzed hospital use and inpatient charges retrospectively for infants hospitalized at a tertiary referral center in the first year of life for cardiac disease. For 93 infants hospitalized between August 1987 and June 1989, there were 1.8 admissions per patient, with a median stay of 14 days; 24.7% required more than 28 days of acute inpatient care. Total hospital charges (excluding professional fees) in the first year of life were $3,417,612, which represents $36,749 per infant and $35,386 per survivor. Reimbursement totaled 93.2% of charges. Multivariate analysis revealed that complex disease, surgery, and length of stay in the intensive care unit were significantly associated with increased charges, while extracardiac anomalies, birth weight, outcome, and type of insurance were not. The economic benefits of averting infant death outweigh the associated costs by as much as 5.4 to 1. We conclude that current treatment of most infants with cardiac disease is both effective and economically beneficial.
authors.affiliation: Division of Pediatric Cardiology, Johns Hopkins Hospital, Baltimore, MD 21205.
authors.forename: G D
authors.initials: GD
authors.lastname: Pearson
authors.forename: L
authors.initials: L
authors.lastname: Kidd
authors.forename: T M
authors.initials: TM
authors.lastname: Beittel
authors.forename: C A
authors.initials: CA
authors.lastname: Neill
mesh_terms: D015142:Baltimore / Q000453:epidemiology; D001724:Birth Weight; D003362:Cost-Benefit Analysis; D006302:Health Services Research; D006331:Heart Diseases / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D017722:Hospital Charges; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000191:economics* / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate