Earlier surgical intervention in congenital heart disease results in better outcome and resource utilization.
BACKGROUND
Congenital heart disease (CHD) accounts for a major proportion of disease in the pediatric age group. The objective of the study was to estimate the cost of illness associated with CHD pre, intra and postoperatively; among patients referred to a tertiary care hospital in Karachi, Pakistan. This is the first study conducted to estimate the cost of managing CHD in Pakistan.


METHODS
A prevalence based cost of illness study design was used to estimate the cost of cardiac surgery (corrective & palliative) for congenital heart defects in children ≤ 5 years of age from June 2006 to June 2009. A total of 120 patients were enrolled after obtaining an informed consent and the data was collected using a pre-tested questionnaire.


RESULTS
The mean age at the time of surgery in group A (1-12 mo age) was 6.08 ± 2.80 months and in group B (1-5 yrs) was 37.10 ± 19.94 months. The cost of surgical admission was found to be significantly higher in the older group, p = 0.001. The total number and cost of post-operative outpatient visits was also higher in group B, p = 0.003. Pre and post operative hospital admissions were not found to be significantly different among the two groups, p = 0.166 and 0.627, respectively. The number of complications were found to be different between the two groups (p = 0.019). Majority of these were contributed by hemorrhage and post-operative seizures.


CONCLUSIONS
This study concluded that significant expenditure is incurred by people with CHD; with the implication that resources could be saved by earlier detection and awareness campaigns.
Aga Khan University, Karachi, Pakistan.
Roheena Z
RZ
Panni
Awais
A
Ashfaq
Muhammad M
MM
Amanullah
D002675:Child, Preschool; D017281:Cost of Illness; D006296:Health Services / Q000706:statistics & numerical data*; D006331:Heart Diseases / Q000151:congenital* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017063:Outcome Assessment, Health Care; D010154:Pakistan / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D019616:Thoracic Surgical Procedures / Q000191:economics