Resource Utilization in the First 2 Years Following Operative Correction for Tetralogy of Fallot: Study Using Data From the Optum's De‐Identified Clinformatics Data Mart Insurance Claims Database

Background Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond the incident hospitalization. Measuring resource utilization, specifically cost and length of stay, provides an integrated measure of morbidi...

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Published inJournal of the American Heart Association Vol. 9; no. 15; p. e016581
Main Authors O'Byrne, Michael L., DeCost, Grace, Katcoff, Hannah, Savla, Jill J., Chang, Joyce, Goldmuntz, Elizabeth, Groeneveld, Peter W., Rossano, Joseph W., Faerber, Jennifer A., Mercer‐Rosa, Laura
Format Journal Article
LanguageEnglish
Published England John Wiley and Sons Inc 04.08.2020
Wiley
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Online AccessGet full text
ISSN2047-9980
2047-9980
DOI10.1161/JAHA.120.016581

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Abstract Background Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond the incident hospitalization. Measuring resource utilization, specifically cost and length of stay, provides an integrated measure of morbidity not appreciable in traditional outcomes. Methods and Results We conducted a retrospective cohort study, using de-identified commercial insurance claims data, of 269 children who underwent operative correction of tetralogy of Fallot from January 2004 to September 2015 with ≥2 years of continuous follow-up (1) to describe resource utilization for the incident hospitalization and subsequent 2 years, (2) to determine whether prolonged length of stay (>7 days) in the incident hospitalization was associated with increased subsequent resource utilization, and (3) to explore whether there was regional variation in resource utilization with both direct comparisons and multivariable models adjusting for known covariates. Subjects with prolonged incident hospitalization length of stay demonstrated greater resource utilization (total cost as well as counts of outpatient visits, hospitalizations, and catheterizations) after hospital discharge ( <0.0001 for each), though the number of subsequent operative and transcatheter interventions were not significantly different. Regional differences were observed in the cost of incident hospitalization as well as subsequent hospitalizations, outpatient visits, and the costs associated with each. Conclusions This study is the first to report short- and medium-term resource utilization following tetralogy of Fallot operative correction. It also demonstrates that prolonged length of stay in the initial hospitalization is associated with increased subsequent resource utilization. This should motivate research to determine whether these differences are because of modifiable factors.
AbstractList Background Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond the incident hospitalization. Measuring resource utilization, specifically cost and length of stay, provides an integrated measure of morbidity not appreciable in traditional outcomes. Methods and Results We conducted a retrospective cohort study, using de-identified commercial insurance claims data, of 269 children who underwent operative correction of tetralogy of Fallot from January 2004 to September 2015 with ≥2 years of continuous follow-up (1) to describe resource utilization for the incident hospitalization and subsequent 2 years, (2) to determine whether prolonged length of stay (>7 days) in the incident hospitalization was associated with increased subsequent resource utilization, and (3) to explore whether there was regional variation in resource utilization with both direct comparisons and multivariable models adjusting for known covariates. Subjects with prolonged incident hospitalization length of stay demonstrated greater resource utilization (total cost as well as counts of outpatient visits, hospitalizations, and catheterizations) after hospital discharge ( <0.0001 for each), though the number of subsequent operative and transcatheter interventions were not significantly different. Regional differences were observed in the cost of incident hospitalization as well as subsequent hospitalizations, outpatient visits, and the costs associated with each. Conclusions This study is the first to report short- and medium-term resource utilization following tetralogy of Fallot operative correction. It also demonstrates that prolonged length of stay in the initial hospitalization is associated with increased subsequent resource utilization. This should motivate research to determine whether these differences are because of modifiable factors.
Background Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond the incident hospitalization. Measuring resource utilization, specifically cost and length of stay, provides an integrated measure of morbidity not appreciable in traditional outcomes. Methods and Results We conducted a retrospective cohort study, using de‐identified commercial insurance claims data, of 269 children who underwent operative correction of tetralogy of Fallot from January 2004 to September 2015 with ≥2 years of continuous follow‐up (1) to describe resource utilization for the incident hospitalization and subsequent 2 years, (2) to determine whether prolonged length of stay (>7 days) in the incident hospitalization was associated with increased subsequent resource utilization, and (3) to explore whether there was regional variation in resource utilization with both direct comparisons and multivariable models adjusting for known covariates. Subjects with prolonged incident hospitalization length of stay demonstrated greater resource utilization (total cost as well as counts of outpatient visits, hospitalizations, and catheterizations) after hospital discharge (P<0.0001 for each), though the number of subsequent operative and transcatheter interventions were not significantly different. Regional differences were observed in the cost of incident hospitalization as well as subsequent hospitalizations, outpatient visits, and the costs associated with each. Conclusions This study is the first to report short‐ and medium‐term resource utilization following tetralogy of Fallot operative correction. It also demonstrates that prolonged length of stay in the initial hospitalization is associated with increased subsequent resource utilization. This should motivate research to determine whether these differences are because of modifiable factors.
Background Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond the incident hospitalization. Measuring resource utilization, specifically cost and length of stay, provides an integrated measure of morbidity not appreciable in traditional outcomes. Methods and Results We conducted a retrospective cohort study, using de-identified commercial insurance claims data, of 269 children who underwent operative correction of tetralogy of Fallot from January 2004 to September 2015 with ≥2 years of continuous follow-up (1) to describe resource utilization for the incident hospitalization and subsequent 2 years, (2) to determine whether prolonged length of stay (>7 days) in the incident hospitalization was associated with increased subsequent resource utilization, and (3) to explore whether there was regional variation in resource utilization with both direct comparisons and multivariable models adjusting for known covariates. Subjects with prolonged incident hospitalization length of stay demonstrated greater resource utilization (total cost as well as counts of outpatient visits, hospitalizations, and catheterizations) after hospital discharge (P<0.0001 for each), though the number of subsequent operative and transcatheter interventions were not significantly different. Regional differences were observed in the cost of incident hospitalization as well as subsequent hospitalizations, outpatient visits, and the costs associated with each. Conclusions This study is the first to report short- and medium-term resource utilization following tetralogy of Fallot operative correction. It also demonstrates that prolonged length of stay in the initial hospitalization is associated with increased subsequent resource utilization. This should motivate research to determine whether these differences are because of modifiable factors.Background Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond the incident hospitalization. Measuring resource utilization, specifically cost and length of stay, provides an integrated measure of morbidity not appreciable in traditional outcomes. Methods and Results We conducted a retrospective cohort study, using de-identified commercial insurance claims data, of 269 children who underwent operative correction of tetralogy of Fallot from January 2004 to September 2015 with ≥2 years of continuous follow-up (1) to describe resource utilization for the incident hospitalization and subsequent 2 years, (2) to determine whether prolonged length of stay (>7 days) in the incident hospitalization was associated with increased subsequent resource utilization, and (3) to explore whether there was regional variation in resource utilization with both direct comparisons and multivariable models adjusting for known covariates. Subjects with prolonged incident hospitalization length of stay demonstrated greater resource utilization (total cost as well as counts of outpatient visits, hospitalizations, and catheterizations) after hospital discharge (P<0.0001 for each), though the number of subsequent operative and transcatheter interventions were not significantly different. Regional differences were observed in the cost of incident hospitalization as well as subsequent hospitalizations, outpatient visits, and the costs associated with each. Conclusions This study is the first to report short- and medium-term resource utilization following tetralogy of Fallot operative correction. It also demonstrates that prolonged length of stay in the initial hospitalization is associated with increased subsequent resource utilization. This should motivate research to determine whether these differences are because of modifiable factors.
Author Goldmuntz, Elizabeth
O'Byrne, Michael L.
Savla, Jill J.
Mercer‐Rosa, Laura
Chang, Joyce
Rossano, Joseph W.
Katcoff, Hannah
Faerber, Jennifer A.
DeCost, Grace
Groeneveld, Peter W.
AuthorAffiliation 1 Division of Cardiology The Children’s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at The University of Pennsylvania Philadelphia PA
6 Corporal Michael J. Crescenz VA Medical Center Philadelphia PA
5 Division of General Internal Medicine Department of Medicine Perelman School of Medicine at The University of Pennsylvania Philadelphia PA
4 Division of Rheumatology The Children’s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at The University of Pennsylvania Philadelphia PA
2 Center for Pediatric Clinical Effectiveness The Children’s Hospital of Philadelphia PA
3 Leonard Davis Institute and Center for Cardiovascular Outcomes, Quality, and Evaluative Research University of Pennsylvania Philadelphia PA
AuthorAffiliation_xml – name: 3 Leonard Davis Institute and Center for Cardiovascular Outcomes, Quality, and Evaluative Research University of Pennsylvania Philadelphia PA
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Cites_doi 10.1161/CIRCULATIONAHA.117.029987
10.1067/mtc.2001.115156
10.1007/s00246-018-1887-7
10.1016/j.jtcvs.2017.09.019
10.1053/j.semtcvs.2014.12.001
10.1016/j.jhealeco.2004.09.011
10.1016/j.ahj.2017.10.018
10.1007/s00246-016-1355-1
10.1001/jamacardio.2018.4255
10.1016/j.jpeds.2011.01.060
10.1016/j.jacc.2015.07.032
10.1016/j.amjcard.2015.10.011
10.1016/j.ahj.2017.07.012
10.1007/s00246-002-0244-y
10.1002/bdra.23262
10.1016/j.jpeds.2017.06.049
10.1016/S0003-4975(97)00503-1
10.1186/s12872-019-0999-1
10.1093/ejcts/ezu182
10.1016/j.jcin.2018.01.253
10.1016/j.jacc.2019.05.057
10.2105/AJPH.2014.301969
10.1016/j.jtcvs.2017.02.066
10.1542/peds.2011-1188
10.1016/j.athoracsur.2017.11.032
10.1177/2150135118808747
10.1161/CIRCOUTCOMES.110.958959
10.1016/j.ahj.2013.05.023
10.1016/j.jtcvs.2012.06.029
10.1016/j.ahj.2015.02.018
10.1016/j.jacc.2009.07.043
10.1016/j.jcin.2017.06.023
10.1007/s00246-013-0788-z
10.1016/j.athoracsur.2011.06.008
10.1161/CIRCULATIONAHA.118.036145
10.1053/j.semtcvs.2018.10.015
10.1161/JAHA.118.011543
10.1016/j.amjcard.2014.09.054
10.1161/JAHA.118.008719
10.1016/j.ahj.2019.08.009
10.1161/CIRCULATIONAHA.117.028972
10.1542/peds.2014-3783
10.1007/s00246-012-0221-z
10.1016/j.athoracsur.2015.04.139
10.1016/j.jtcvs.2009.03.071
10.1542/peds.2004-2071
10.1542/peds.2013-2870
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Issue 15
Keywords congenital heart disease
health services research
outcomes
pediatrics
Language English
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For Sources of Funding and Disclosures, see page 10.
Dr O'Byrne and Ms DeCost are co‐first authors.
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References e_1_3_2_26_2
e_1_3_2_49_2
e_1_3_2_27_2
e_1_3_2_48_2
e_1_3_2_28_2
e_1_3_2_29_2
O'Byrne ML (e_1_3_2_14_2) 2015; 169
e_1_3_2_41_2
e_1_3_2_40_2
e_1_3_2_20_2
e_1_3_2_43_2
e_1_3_2_21_2
e_1_3_2_42_2
e_1_3_2_22_2
e_1_3_2_45_2
e_1_3_2_23_2
e_1_3_2_44_2
e_1_3_2_24_2
e_1_3_2_47_2
e_1_3_2_25_2
e_1_3_2_46_2
e_1_3_2_9_2
e_1_3_2_15_2
e_1_3_2_38_2
e_1_3_2_8_2
e_1_3_2_16_2
e_1_3_2_37_2
e_1_3_2_7_2
e_1_3_2_17_2
e_1_3_2_6_2
e_1_3_2_18_2
e_1_3_2_39_2
e_1_3_2_19_2
e_1_3_2_30_2
e_1_3_2_32_2
e_1_3_2_10_2
e_1_3_2_31_2
e_1_3_2_5_2
e_1_3_2_11_2
e_1_3_2_34_2
e_1_3_2_4_2
e_1_3_2_12_2
e_1_3_2_33_2
e_1_3_2_3_2
e_1_3_2_13_2
e_1_3_2_36_2
e_1_3_2_2_2
e_1_3_2_35_2
References_xml – ident: e_1_3_2_35_2
  doi: 10.1161/CIRCULATIONAHA.117.029987
– ident: e_1_3_2_5_2
  doi: 10.1067/mtc.2001.115156
– ident: e_1_3_2_40_2
  doi: 10.1007/s00246-018-1887-7
– ident: e_1_3_2_8_2
  doi: 10.1016/j.jtcvs.2017.09.019
– ident: e_1_3_2_10_2
  doi: 10.1053/j.semtcvs.2014.12.001
– ident: e_1_3_2_28_2
  doi: 10.1016/j.jhealeco.2004.09.011
– ident: e_1_3_2_42_2
  doi: 10.1016/j.ahj.2017.10.018
– ident: e_1_3_2_6_2
  doi: 10.1007/s00246-016-1355-1
– ident: e_1_3_2_2_2
  doi: 10.1001/jamacardio.2018.4255
– ident: e_1_3_2_47_2
  doi: 10.1016/j.jpeds.2011.01.060
– ident: e_1_3_2_25_2
  doi: 10.1016/j.jacc.2015.07.032
– ident: e_1_3_2_15_2
  doi: 10.1016/j.amjcard.2015.10.011
– ident: e_1_3_2_29_2
  doi: 10.1016/j.ahj.2017.07.012
– ident: e_1_3_2_48_2
  doi: 10.1007/s00246-002-0244-y
– ident: e_1_3_2_38_2
  doi: 10.1002/bdra.23262
– ident: e_1_3_2_13_2
  doi: 10.1016/j.jpeds.2017.06.049
– volume: 169
  start-page: e2
  issue: 727
  year: 2015
  ident: e_1_3_2_14_2
  article-title: Cost comparison of transcatheter and operative closures of ostium secundum atrial septal defects
  publication-title: Am Heart J
– ident: e_1_3_2_19_2
  doi: 10.1016/S0003-4975(97)00503-1
– ident: e_1_3_2_27_2
  doi: 10.1186/s12872-019-0999-1
– ident: e_1_3_2_4_2
  doi: 10.1093/ejcts/ezu182
– ident: e_1_3_2_43_2
  doi: 10.1016/j.jcin.2018.01.253
– ident: e_1_3_2_26_2
  doi: 10.1016/j.jacc.2019.05.057
– ident: e_1_3_2_46_2
  doi: 10.2105/AJPH.2014.301969
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Snippet Background Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond...
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StartPage e016581
SubjectTerms Child, Preschool
congenital heart disease
Databases, Factual
Female
health services research
Humans
Infant
Length of Stay - economics
Length of Stay - statistics & numerical data
Male
Original Research
outcomes
pediatrics
Retrospective Studies
Tetralogy of Fallot - economics
Tetralogy of Fallot - surgery
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Title Resource Utilization in the First 2 Years Following Operative Correction for Tetralogy of Fallot: Study Using Data From the Optum's De‐Identified Clinformatics Data Mart Insurance Claims Database
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