Affiliation:
1. Stanford University School of Medicine Stanford CA
2. New York State Department of Health Albany NY
3. Department of Pediatrics University of Utah Salt Lake City UT
4. University of Colorado Aurora CO
5. Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities Atlanta GA
6. Albert Einstein College of Medicine Bronx NY
7. Duke University Durham NC
8. Rollins School of Public Health Emory University Atlanta GA
9. East Carolina University Greenville NC
10. School of Public Health University at Albany Rensselaer NY
11. Mt. Sinai Medical Center New York NY
12. Emory University School of Medicine Atlanta GA
Abstract
Background
We sought to characterize health care usage for adolescents with congenital heart defects (CHDs) using population‐based multisite surveillance data.
Methods and Results
Adolescents aged 11 to 18 years with ≥1 CHD‐related diagnosis code and residing in 5 US sites were identified in clinical and administrative data sources for the years 2011 to 2013. Sites linked data on all inpatient, emergency department (ED), and outpatient visits. Multivariable log‐binomial regression models including age, sex, unweighted Charlson comorbidity index, CHD severity, cardiology visits, and insurance status, were used to identify associations with inpatient, ED, and outpatient visits. Of 9626 eligible adolescents, 26.4% (n=2543) had severe CHDs and 21.4% had Charlson comorbidity index >0. At least 1 inpatient, ED, or outpatient visit was reported for 21%, 25%, and 96% of cases, respectively. Cardiology visits, cardiac imaging, cardiac procedures, and vascular procedures were reported for 38%, 73%, 10%, and 5% of cases, respectively. Inpatient, ED, and outpatient visits were consistently higher for adolescents with severe CHDs compared with nonsevere CHDs. Adolescents with severe and nonsevere CHDs had higher health care usage compared with the 2011 to 2013 general adolescent US population. Adolescents with severe CHDs versus nonsevere CHDs were twice as likely to have at least 1 inpatient visit when Charlson comorbidity index was low (Charlson comorbidity index =0). Adolescents with CHDs and public insurance, compared with private insurance, were more likely to have inpatient (adjusted prevalence ratio, 1.5 [95% CI, 1.3–1.7]) and ED (adjusted prevalence ratio, 1.6 [95% CI, 1.4–1.7]) visits.
Conclusions
High resource usage by adolescents with CHDs indicates a substantial burden of disease, especially with public insurance, severe CHDs, and more comorbidities.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
1 articles.
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