title: Hospital Charges for Pediatric Heart Failure-Related Hospitalizations from 2000 to 2009.
abstract: Scarce data exist regarding costs of pediatric heart failure-related hospitalizations (HFRH) or how costs have changed over time. Pediatric HFRH costs, due to advances in management, will have increased significantly over time. A retrospective analysis of Healthcare Cost and Utilization Project Kids' Inpatient Database was performed on all pediatric HFRH. Inflation-adjusted charges are used as a proxy for cost. There were a total of 33,189 HFRH captured from 2000 to 2009. Median charges per HFRH rose from $35,079 in 2000 to $72,087 in 2009 (p < 0.0001). The greatest median charges were incurred in patients on extracorporeal membrane oxygenation ($442,134 vs $53,998) or ventricular assist devices ($462,647 vs $55,151). Comorbidities, including sepsis ($207,511 vs $48,995), renal failure ($180,624 vs $52,812), stroke ($198,260 vs $54,974) and respiratory failure ($146,200 vs $48,797), were associated with greater charges (p < 0.0001). Comorbidities and use of mechanical support increased over time. After adjusting for these factors, later year remained associated with greater median charges per HFRH (p < 0.0001). From 2000 to 2009, there has been an almost twofold increase in pediatric HFRH charges, after adjustment for inflation. Although comorbidities and use of mechanical support account for some of this increase, later year remained independently associated with greater charges. Further study is needed to understand potential factors driving these higher costs over time and to identify more cost-effective therapies in this population.
authors.affiliation: Cardiac Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA. nandid@email.chop.edu.
authors.forename: Deipanjan
authors.initials: D
authors.lastname: Nandi
authors.affiliation: Cardiac Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA.
authors.forename: Kimberly Y
authors.initials: KY
authors.lastname: Lin
authors.affiliation: Cardiac Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: O'Connor
authors.affiliation: The Children's Hospital of Philadelphia/Westat, Biostatistics and Data Management, Philadelphia, PA, USA.
authors.forename: Okan U
authors.initials: OU
authors.lastname: Elci
authors.affiliation: Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Johns Hopkins All Children's Heart Institute, Saint Petersburg, FL, USA.
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Decker
authors.affiliation: Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Jack F
authors.initials: JF
authors.lastname: Price
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.
authors.forename: Farhan
authors.initials: F
authors.lastname: Zafar
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.
authors.forename: David L S
authors.initials: DL
authors.lastname: Morales
authors.affiliation: Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Susan W
authors.initials: SW
authors.lastname: Denfield
authors.affiliation: Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Dreyer
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Jefferies
authors.affiliation: Cardiac Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Rossano
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000639:trends*; D006333:Heart Failure / Q000191:economics*; D006353:Heart-Assist Devices / Q000191:economics*; D017722:Hospital Charges / Q000639:trends*; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D051437:Renal Insufficiency / Q000191:economics; D012131:Respiratory Insufficiency / Q000191:economics; D012189:Retrospective Studies; D020521:Stroke / Q000191:economics; D014481:United States; D055815:Young Adult
keywords: Cardiomyopathy; Costs; Heart failure; Value