Utilization Patterns Identified Among Young Adults With Congenital Heart Defects

Researchers recently analyzed health care utilization patterns and costs associated with adolescents and young adults with congenital heart defects. Based on their findings, including increased hospital admission volume and costs for these patients, the researchers said transition programs for this population may help continue appropriate cardiac care as these patients move to adulthood.  

“Most individuals born with congenital heart defects survive to adulthood, but healthcare utilization patterns for adolescents and adults with congenital heart defects have not been well described,” the study authors wrote. “We sought to characterize the health care utilization patterns and associated costs for adolescents and young adults with congenital heart defects.”

In order to understand utilization and patterns, they study authors examined 2009-2013 New York State inpatient admissions of individuals ages 11-30 years with ≥1 congenital heart defect diagnosis codes recorded during any admission. They used generalized estimating equations in order to understand the associations between inpatients costs and sociodemographic and clinical variables.  

For the study, they research team identified 5100 unique individuals with 9593 corresponding hospitalizations over the study period.  

According to the findings, the median inpatient cost and length of stay were $10,720 and 3.0 days per admission, respectively; 55.1% were emergency admissions. Additionally, from 2009 to 2013, admission volume increased 48.7% (1588 admissions to 2287 admissions), and total inpatient costs increased 91.8% over the same time period ($27.2 million to $52.2 million).  

The researchers noted that both admissions and costs rose more sharply over the time of the study for patients with nonsevere congenital heart defects compared to severe cases. Additionally they noted that characteristics linked with higher costs:  

• were length of stay;
• severe congenital heart defect;
• cardiac/vascular hospitalization classification;
• surgical procedures;
• greater severity of illness; and
• admission in New York City. 

“This study provides an informative baseline of health care utilization patterns and associated costs among adolescents and young adults with CHDs in New York State,” they concluded.

“Structured transition programs may aid in keeping this population in appropriate cardiac care as they move to adulthood.” 

—Julie Gould  

Reference:

Hsu WH, Sommerhalter KM, McGarry CE, et al. Inpatient admissions and costs for adolescents and young adults with congenital heart defects in New York, 2009-2013 [published online ahead of print, 2020 Sep 29]. Birth Defects Res. 2020;10.1002/bdr2.1809. doi:10.1002/bdr2.1809