Congenital heart defects are the most common birth defects. Each year, more than 30,000 congenital heart operations are performed in US children’s hospitals. Congenital heart defects are also one of the most expensive paediatric conditions to treat, according to researchers who aimed to determine whether it is possible to deliver high-quality heart care at a low cost. Many current initiatives are intended to both improve quality of care and reduce costs.
For this heart disease study, the investigators used a unique set of merged clinical data and cost data from the Society of Thoracic Surgeons and Children’s Hospital Association. They found that costs of care differed by five-fold across the 27 hospitals studied. The results also showed that:
- The lowest-cost hospitals had significantly lower mortality rates compared to the other hospitals.
- The low-cost hospitals also had shorter lengths of stay after surgery and fewer post-operative complications.
- The low-cost hospitals tended to be larger volume centres, which were able to achieve these outcomes despite treating a more high-risk patient population.
“The care of children with congenital heart conditions is complex and requires significant investment of resources. It has been unclear whether there are centres able to provide high-quality care, but also at a low cost,” said lead author Sara K. Pasquali, MD, associate professor of paediatric cardiology within the Michigan Congenital Heart Center at U-M’s C.S. Mott Children’s Hospital and U-M’s Center for Healthcare Outcomes and Policy.
These relationships should be considered in the formulation of policies seeking to optimise healthcare value in this population and others. "For example, one would not want to provide incentives to low-cost hospitals if these low costs were due to poor clinical outcomes, such as high rates of mortality,” said Dr. Pasquali, who is a member of the Institute for Healthcare Policy and Innovation at U-M.
What this new study shows, Dr. Pasquali noted, is that lower-cost hospitals seem to be doing the right thing: they are delivering the highest-quality care to children undergoing heart surgery.
“In addition, these results suggest that initiatives aiming to improve quality of care and outcomes, may also hold the potential to reduce costs in this population," the study's lead author added.
The study was funded by the National Heart, Lung, and Blood Institute.
The specialists at the Congenital Heart Center at C.S. Mott Children's Hospital are skilled at treating the full spectrum of congenital heart conditions. As one of the highest volume programmes in the country, the Center performs approximately 900 procedures a year. U.S. News and World Report ranked the Center's programme in the top 10 in the country for cardiology and heart surgery.
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