Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct;97(10):664-72.
doi: 10.1002/bdra.23165. Epub 2013 Sep 2.

Hospitalizations, costs, and mortality among infants with critical congenital heart disease: how important is timely detection?

Cora Peterson  1 , April Dawson, Scott D Grosse, Tiffany Riehle-Colarusso, Richard S Olney, Jean Paul Tanner, Russell S Kirby, Jane A Correia, Sharon M Watkins, Cynthia H Cassell
Affiliations

Hospitalizations, costs, and mortality among infants with critical congenital heart disease: how important is timely detection?

Cora Peterson et al. Birth Defects Res A Clin Mol Teratol. 2013 Oct.

Abstract

Background: Critical congenital heart disease (CCHD) was recently added to the U.S. Recommended Uniform Screening Panel for newborns. States considering screening requirements may want more information about the potential impact of screening. This study examined potentially avoidable mortality among infants with late detected CCHD and assessed whether late detection was associated with increased hospital resource use during infancy.

Methods: This was a state-wide, population-based, observational study of infants with CCHD (n = 3603) born 1998 to 2007 identified by the Florida Birth Defects Registry. We examined 12 CCHD conditions that are targets of newborn screening. Late detection was defined as CCHD diagnosis after the birth hospitalization. Deaths potentially avoidable through screening were defined as those that occurred outside a hospital following birth hospitalization discharge and those that occurred within 3 days of an emergency readmission.

Results: For 23% (n = 825) of infants, CCHD was not detected during the birth hospitalization. Death occurred among 20% (n = 568/2,778) of infants with timely detected CCHD and 8% (n = 66/825) of infants with late detected CCHD, unadjusted for clinical characteristics. Potentially preventable deaths occurred in 1.8% (n = 15/825) of infants with late detected CCHD (0.4% of all infants with CCHD). In multivariable models adjusted for selected characteristics, late CCHD detection was significantly associated with 52% more admissions, 18% more hospitalized days, and 35% higher inpatient costs during infancy.

Conclusion: Increased CCHD detection at birth hospitals through screening may lead to decreased hospital costs and avoid some deaths during infancy. Additional studies conducted after screening implementation are needed to confirm these findings.

Keywords: birth defects surveillance; congenital; costs and cost analysis; heart defects; pediatrics.

PubMed Disclaimer

Conflict of interest statement

The authors reported no conflicts of interest.

References

    1. Aamir T, Kruse L, Ezeakudo O. Delayed diagnosis of critical congenital cardiovascular malformations (ccvm) and pulse oximetry screening of newborns. Acta Paediatr. 2007;96:1146–1149. - PubMed
    1. Agency for Health Care Administration (AHCA) [Accessed April 22, 2013];Florida Agency for Health Care Administration. Available at: http://ahca.myflorida.-com/
    1. Agency for Healthcare Research and Quality (AHRQ) [Accessed May 20, 2012];Health Care Utilization Project. Cost-to-charge ratio files. Available at: http://www.hcup-us.ahrq.gov/db/state/costtocharge.jsp.
    1. American Academy of Pediatrics Committee on Fetus and Newborn. Levels of neonatal care. Pediatrics. 2004;114:1341–1347. - PubMed
    1. Centers for Disease Control and Prevention. [Accessed April 22, 2013];Screening for critical congenital heart defects. Available at: http://www.cdc.gov/ncbddd/pediatricgenetics/documents/CCHD-factsheet.pdf.

Publication types