title: Inpatient admissions and costs of congenital heart disease from adolescence to young adulthood.
abstract: BACKGROUND
  Health care utilization patterns and associated costs of congenital heart disease (CHD) in young adulthood are not well understood.
  
  
  METHODS
  California State Inpatient Databases 2005 to 2009 were used to conduct a retrospective study on inpatient admissions of CHD patients 10 to 29 years old (n = 7,419) and of all patients of the same age (n = 1,195,233).
  
  
  RESULTS
  Compared with all patients, annual admission costs of CHD patients monotonically decreased, from $13.9 million at age 10 to 14 years to $7.2 million at age 25 to 29 years, which were due to lower costs per admission and somewhat fewer annual hospitalizations. Admissions from the emergency department in CHD patients increased with age regardless of insurance status: at age 25 to 29 years, 62% of admissions with public insurance, 43% with private insurance, and 78% with no insurance were admitted from the emergency department. Cardiac surgery, catheterization, and electrophysiologic study admissions decreased with age in CHD patients, whereas admissions due to arrhythmia and congestive heart failures became more prevalent. Results from multivariate linear regression in CHD patients showed that cardiac surgery was the most costly factor, associated with $29,543 more in costs per admission, followed by the use of a children's hospital, at $10,533. Factors predicting lower costs included female gender, low-complexity CHD, and shorter stay, all P < .001.
  
  
  CONCLUSIONS
  Compared with adolescents, young adults with CHD use fewer resources because the natural history of CHD results in fewer surgical admissions and more frequent but less expensive medical admissions.
authors.affiliation: Harbor-UCLA Medical Center & Los Angeles Biomedical Research Institute, Torrance, California.
authors.forename: Yang
authors.initials: Y
authors.lastname: Lu
authors.affiliation: University of Southern California, Los Angeles, CA.
authors.forename: Garima
authors.initials: G
authors.lastname: Agrawal
authors.affiliation: University of Southern California, Los Angeles, CA.
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Lin
authors.affiliation: University of Southern California, Los Angeles, CA & Children's Hospital Los Angeles, Los Angeles, CA. Electronic address: RWilliams@chla.usc.edu.
authors.forename: Roberta G
authors.initials: RG
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D006330:Heart Defects, Congenital / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D017722:Hospital Charges / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies