Costs of congenital heart operations vary among hospitals
Of all birth defects, congenital heart defects are associated with the highest average hospital charges, length of stay, and mortality. A team of researchers examined cost data from 20 U.S. hospitals for four congenital heart operations of varying levels of complexity. They examined the records of 2,124 patients up to 18 years of age undergoing congenital heart surgery from 2001 to 2007. As expected, total hospital costs rose with the increasing complexity of the operation from a median of $12,761 for atrial septal defect repair to a median of $55,430 for the arterial switch operation.
Accounting for various patient and center factors and length of stay, the proportion of total cost variation explained by center decreased as the complexity of the surgery increased: 19 percent for atrial septal defect repair, 11 percent for ventricular septal defect repair, 6 percent for tetralogy of Fallot repair, and 3 percent for arterial switch operation. Cost differences between centers were most prominent for the lower complexity procedures. Higher surgical volume was associated with significantly lower hospital costs, but only for the less complex surgeries.
The researchers concluded that although higher complexity operations account for greater relative cost, there is greater variation across institutions for lower complexity operations. Thus, initial efforts to reduce cost variation between centers may be best focused on lower complexity, common operations. The study was supported in part by the Agency for Healthcare Research and Quality (HS16957).
See "Center variation in hospital costs for patients undergoing congenital heart surgery," by Sara K. Pasquali, M.D., Jie-Lena Sum, M.S., Phil D'Almada, M.S., and others in Circulation and Cardiovascular Quality Outcomes 4, p. 306-312, 2011.
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