title: Inpatient costs and charges for surgical treatment of hypoplastic left heart syndrome.
abstract: OBJECTIVE
  Hypoplastic left heart syndrome (HLHS) is one of the most serious congenital cardiac anomalies. Typically, it is managed with a series of 3 palliative operations or cardiac transplantation. Our goal was to quantify the inpatient resource burden of HLHS across multiple academic medical centers.
  
  
  METHODS
  The University HealthSystem Consortium is an alliance of 101 academic medical centers and 178 affiliated hospitals that share diagnostic, procedural, and financial data on all discharges. We examined inpatient resource use by patients with HLHS who underwent a staged palliative procedure or cardiac transplantation between 1998 and 2007.
  
  
  RESULTS
  Among 1941 neonates, stage 1 palliation (Norwood or Sano procedure) had a median length of stay (LOS) of 25 days and charges of $214,680. Stage 2 and stage 3 palliation (Glenn and Fontan procedures, respectively) had median LOS and charges of 8 days and $82,174 and 11 days and $79,549, respectively. Primary neonatal transplantation had an LOS of 87 days and charges of $582,920, and rescue transplantation required 36 days and $411,121. The median inpatient wait time for primary and rescue transplants was 42 and 6 days, respectively. Between 1998 and 2007, the LOS for stage 1 palliation increased from 16 to 28 days and inflation-adjusted charges increased from $122,309 to $280,909, largely because of increasing survival rates (57% in 1998 and 83% in 2007).
  
  
  CONCLUSIONS
  Patients with HLHS demand considerable inpatient resources, whether treated with the Norwood-Glenn-Fontan procedure pathway or cardiac transplantation. Improved survival rates have led to increased hospital stays and costs.
authors: Department of Pediatrics, University of Virginia Health System, Charlottesville, VA 22908-0386, USA.
authors: Peter N
authors: PN
authors: Dean
authors: Diane G
authors: DG
authors: Hillman
authors: Kimberly E
authors: KE
authors: McHugh
authors: Howard P
authors: HP
authors: Gutgesell
mesh_terms: D000046:Academic Medical Centers; D006348:Cardiac Surgical Procedures / Q000191:economics* / Q000379:methods / Q000401:mortality; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D016027:Heart Transplantation / Q000191:economics; D017722:Hospital Charges; D017721:Hospital Costs; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000191:economics* / Q000401:mortality / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D008297:Male; D010166:Palliative Care / Q000191:economics / Q000379:methods; D011183:Postoperative Complications / Q000191:economics / Q000401:mortality / Q000628:therapy; D018570:Risk Assessment; D014481:United States