title: Hospital Resource Utilization for Common Noncardiac Diagnoses in Adult Survivors of Single Cardiac Ventricle.
abstract: Single ventricle congenital heart disease (SV CHD) has transformed from a nearly universally fatal condition to a chronic illness. As the number of adults living with SV CHD continues to increase, there needs to be an understanding of health care resource utilization (HCRU), particularly for noncardiac conditions, for this patient population. We performed a retrospective database review of the University HealthSystem Consortium Clinical Database/Resource Manager for adult patients with SV CHD hospitalized for noncardiac conditions from January 2011 to November 2014. Patients with SV CHD were identified using International Classification of Disease (ICD)-9 codes associated with SV CHD (hypoplastic left heart, tricuspid atresia, and SV) and stratified into 2 groups by age (18 to 29 years and 30 to 40 years). Direct cost, length of stay (LOS), intensive care unit (ICU) admission rate and mortality data were compared with age-matched patients without CHD. There were 2,083,651 non-CHD and 590 SV CHD admissions in Group 1 and 2,131,046 non-CHD and 297 SV CHD admissions in Group 2. There was no difference in LOS in Group 1, but there were higher costs for several diagnoses. LOS and costs were higher for several diagnoses in Group 2. ICU admission rate and in-hospital mortality were higher for several diagnoses for patients with SV CHD in both groups. In conclusion, adults with SV CHD admitted for noncardiac diagnoses have higher HCRU (longer LOS and higher ICU admission rates) compared with similarly aged patients without CHD. These findings stress the importance of good primary care in this population with complex, chronic cardiac disease to prevent hospitalizations and higher HCRU.
authors.affiliation: Department of Pediatrics (Cardiology), University of Arizona, Tucson, Arizona. Electronic address: mseckeler@peds.arizona.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Seckeler
authors.affiliation: Arizona Pediatric Cardiology, Phoenix Children's Hospital, Phoenix, Arizona.
authors.forename: Tabitha G
authors.initials: TG
authors.lastname: Moe
authors.affiliation: Department of Pediatrics, University of Arizona, Tucson, Arizona.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Thomas
authors.affiliation: University of Arizona College of Medicine, Tucson, Arizona.
authors.forename: Omar
authors.initials: O
authors.lastname: Meziab
authors.affiliation: Department of Pediatrics (Cardiology), University of Arizona, Tucson, Arizona.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Andrews
authors.affiliation: Sarver Heart Center, University of Arizona, Tucson, Arizona.
authors.forename: Elissa
authors.initials: E
authors.lastname: Heller
authors.affiliation: Department of Pediatrics (Cardiology), University of Arizona, Tucson, Arizona.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Klewer
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000401:mortality; D006352:Heart Ventricles / Q000002:abnormalities*; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D012189:Retrospective Studies; D017741:Survivors; D055815:Young Adult