Pediatric versus adult cardiomyopathy and heart failure-related hospitalizations: a value-based analysis.

TitlePediatric versus adult cardiomyopathy and heart failure-related hospitalizations: a value-based analysis.
Publication TypeJournal Article
Year of Publication2015
AuthorsWittlieb-Weber CA, Lin KY, Zaoutis TE, O'Connor MJ, Gerald K, Paridon SM, Shaddy RE, Rossano JW
JournalJ Card Fail
Date Published01/2015
KeywordsAdolescent, Adult, Aged, Cardiomyopathies, Child, Child, Preschool, Female, Health Care Costs, Heart Failure, Hospitalization, Humans, Infant, Male, Middle Aged, Patient Protection and Affordable Care Act, Retrospective Studies, United States, Value-Based Purchasing, Young Adult

BACKGROUND: Value-based health care is a proposed driver for reimbursement under the Affordable Care Act, with value broadly defined as outcomes divided by cost. Data on value-based health care in pediatric heart failure are scarce.

METHODS AND RESULTS: A retrospective analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database and Nationwide Inpatient Sample was performed for pediatric and adult cardiomyopathy and heart failure-related hospitalizations. The study included 5,689 pediatric and 473,416 adult hospitalizations. Pediatric cardiomyopathy and heart failure hospitalizations were significantly longer than adult hospitalizations (mean ± SE 16.2 ± 0.7 days vs 6.8 ± 0.1 days; P < .001). Overall mortality was greater for pediatric hospitalizations (7.7% vs 5.6%; P < .001), although it decreased over time for both pediatric and adult hospitalizations. Charges were greater for pediatric hospitalizations, both overall ($116,483 ± $5,735 vs $40,662 ± $1,419; P < .001) and for all years evaluated.

CONCLUSIONS: In a value-based model, pediatric cardiomyopathy and heart failure-related hospitalizations are associated with worse outcomes and greater charges than adult hospitalizations. More research is needed to understand the cost effectiveness of pediatric heart failure treatment and to reduce the burden on the health care system.

Alternate JournalJ. Card. Fail.
PubMed ID25451708