ArticleThe Annals of thoracic surgery2015
Quality-Cost Relationship in Congenital Heart Surgery.
Article in The Annals of thoracic surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of the Association Between Hospital Cost/price and the Quality of Care.Applied health economics and health policy · 2020Pooled it
- A Translational Paradigm for Univentricular Heart Disease: Single-Stage Neonatal Repair with Adaptive Control of Cavopulmonary Flow.Cardiovascular engineering and technology · 2026Article
- Quality, outcome, and cost of care provided to very low birth weight infants in California.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Cumulative In-Hospital Costs Associated With Single-Ventricle Palliation.JACC. Advances · 2022Article
- Health Care Policy and Congenital Heart Disease: 2020 Focus on Our 2030 Future.Journal of the American Heart Association · 2021Article
- Examining the Relationship between Cost and Quality of Care in the Neonatal Intensive Care Unit and Beyond.Children (Basel, Switzerland) · 2020Review
- Factors That Contribute to Cost Differences Based on ICU of Admission in Neonates Undergoing Congenital Heart Surgery: A Novel Decomposition Analysis.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2020Article
- Estimating Resource Utilization in Congenital Heart Surgery.The Annals of thoracic surgery · 2020Article
- 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.Journal of the American Heart Association · 2020Article
- Interhospital Variation in the Costs of Pediatric/Congenital Cardiac Catheterization Laboratory Procedures: Analysis of Data From the Pediatric Health Information Systems Database.Journal of the American Heart Association · 2019Observational
- Hospital Costs Related to Early Extubation After Infant Cardiac Surgery.The Annals of thoracic surgery · 2019Article
- Center Variation in Hospital Costs for Pediatric Heart Transplantation: The Relationship Between Cost and Outcomes.Pediatric cardiology · 2019Article
- Development of a Congenital Heart Surgery Composite Quality Metric: Part 1-Conceptual Framework.The Annals of thoracic surgery · 2019Review
- Longitudinal Health Care Cost in Hypoplastic Left Heart Syndrome Palliation.Pediatric cardiology · 2018Article
- Admission to dedicated pediatric cardiac intensive care units is associated with decreased resource use in neonatal cardiac surgery.The Journal of thoracic and cardiovascular surgery · 2018Article
- Cost Variation Across Centers for the Norwood Operation.The Annals of thoracic surgery · 2018Article
- A unique linkage of administrative and clinical registry databases to expand analytic possibilities in pediatric heart transplantation research.American heart journal · 2017Article
- Pediatric Intensive Care Databases for Quality Improvement.Journal of pediatric intensive care · 2016Review
- Congenital heart disease and the cost of mortality.Open heart · 2016Article
- Resource and cost considerations in treating hypoplastic left heart syndrome.Pediatric health, medicine and therapeutics · 2016Review
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13 authors.
Funding
Abstract
backgroundThere is an increasing focus on optimizing health care quality and reducing costs. The care of children undergoing heart surgery requires significant investment of resources, and it remains unclear how costs of care relate to quality. We evaluated this relationship across a multicenter cohort.
methodsClinical data from The Society of Thoracic Surgeons Database were merged with cost data from the Pediatric Health Information Systems Database for children undergoing heart surgery (2006 to 2010). Hospital-level costs were modeled using Bayesian hierarchical methods adjusting for case-mix, and hospitals were categorized into cost tertiles. The primary quality metric evaluated was in-hospital mortality.
resultsOverall, 27 hospitals (30,670 patients) were included. Median adjusted cost per case was $82,360 and varied fivefold across hospitals, while median adjusted mortality was 3.4% and ranged from 2.4% to 5.0% across hospitals. Overall, hospitals in the lowest cost tertile had significantly lower adjusted mortality rates compared with the middle and high cost tertiles (2.5% vs 3.8% and 3.5%, respectively, both p < 0.001). When assessed at the individual hospital level, most (75%) but not all hospitals in the lowest cost tertile were also in the lowest mortality tertile. Similar relationships were seen across the spectrum of surgical complexity. Lower cost hospitals also had shorter length of stay and trends toward fewer major complications.
conclusionsLowest cost hospitals generally deliver the highest quality care for children undergoing heart surgery, although there is some variation in this relationship. This information is important in the design of initiatives aiming to optimize health care value in this population.
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