Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals Risk Factors for High Resource Utilization and Association With Inpatient Death
Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals Risk Factors for High Resource Utilization and Association With Inpatient Death
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DOI：
10.1161/circoutcomes.111.963223
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发表时间：
2011-11-01
影响因子：
6.9
通讯作者：
Benavidez, Oscar J.
中科院分区：
文献类型：
--
作者：
Kim, Yuli Y.;Gauvreau, Kimberlee;Benavidez, Oscar J.
儿科医院经常对患有先天性心脏病的成人进行先天性心脏病手术。这些入院对儿科医院资源的影响尚不清楚。我们的目标是研究资源使用成人接受先天性心脏病手术在儿科医院，探讨高资源使用（HRU）和住院死亡之间的关联，并确定HRU的危险factors.Methods和Results-We获得的住院数据从2000年至2008年42家儿科医院和成人先天性心脏病（ACH）手术入院。我们将HRU入院定义为超过医院总费用第90百分位数的患者。我们使用广义估计方程进行多变量分析，以确定HRU的危险因素。在儿科医院97563例先天性心脏病手术中，3061例（3.1%）为成人，占总住院费用的2.2%。HRU的门槛是医院费用总额>= 213 803美元。虽然HRU的入院人数占入院人数的10%，但他们占所有ACH手术入院费用的34%。HRU住院患者的死亡率为16%，其他住院患者的死亡率为0.7%（P
Background-Pediatric hospitals frequently perform congenital heart surgery in adults with congenital heart disease. The impact of these admissions on pediatric hospital resources is unknown. Our goals were to examine resource use by adults undergoing congenital heart surgery in pediatric hospitals, explore the association between high resource use (HRU) and inpatient death, and identify HRU risk factors.Methods and Results-We obtained inpatient data from 42 pediatric hospitals from 2000 to 2008 and selected adult congenital heart (ACH) surgery admissions. We defined HRU admissions as those exceeding the 90th percentile for total hospital charges. We performed multivariable analyses using generalized estimating equations to identify risk factors for HRU. Of 97 563 congenital heart surgery admissions to pediatric hospitals, 3061 (3.1%) were adults, accounting for 2.2% of total hospital charges. The threshold for HRU was total hospital charges >=$213 803. Although HRU admissions comprised 10% of admissions, they accounted for 34% of charges for all ACH surgery admissions. Mortality rate was 16% for HRU admissions and 0.7% for others (P