title: Hospitalizations and associated costs in a population-based study of children with Down syndrome born in Florida.
abstract: BACKGROUND
  Our objective was to examine differences in hospital resource usage for children with Down syndrome by age and the presence of other birth defects, particularly severe and nonsevere congenital heart defects (CHDs).
  
  
  METHODS
  This was a retrospective, population-based, statewide study of children with Down syndrome born 1998 to 2007, identified by the Florida Birth Defects Registry (FBDR) and linked to hospital discharge records for 1 to 10 years after birth. To evaluate hospital resource usage, descriptive statistics on number of hospitalized days and hospital costs were calculated. Results were stratified by isolated Down syndrome (no other coded major birth defect); presence of severe and nonsevere CHDs; and presence of major FBDR-eligible birth defects without CHDs.
  
  
  RESULTS
  For 2552 children with Down syndrome, there were 6856 inpatient admissions, of which 68.9% occurred during the first year of life (infancy). Of the 2552 children, 31.7% (n = 808) had isolated Down syndrome, 24.0% (n = 612) had severe CHDs, 36.3% (n = 927) had nonsevere CHDs, and 8.0% (n = 205) had a major FBDR-eligible birth defect in the absence of CHD. Infants in all three nonisolated DS groups had significantly higher hospital costs compared with those with isolated Down syndrome. From infancy through age 4, children with severe CHDs had the highest inpatient costs compared with children in the other sub-groups.
  
  
  CONCLUSIONS
  Results support findings that for children with Down syndrome the presence of other anomalies influences hospital use and costs, and children with severe CHDs have greater hospital resource usage than children with other CHDs or major birth defects without CHDs.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia.
authors.forename: April L
authors.initials: AL
authors.lastname: Dawson
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: Cassell
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Oster
authors.forename: Richard S
authors.initials: RS
authors.lastname: Olney
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Tanner
authors.forename: Russell S
authors.initials: RS
authors.lastname: Kirby
authors.forename: Jane
authors.initials: J
authors.lastname: Correia
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
mesh_terms: D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications / Q000191:economics* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005431:Florida / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000150:complications / Q000191:economics* / Q000453:epidemiology / Q000473:pathology; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Down syndrome; birth defects surveillance; congenital heart defect; cost, hospital