Abstract 11319: Rising Charges for Pediatric Catheter Ablation from 1997 to 2006
Introduction: Pediatric catheter ablation has been shown to be cost-effective compared to medication and surgery, but temporal trends in charges for ablation have not been evaluated.
Objectives/Methods: Using administrative data from the Kids' Inpatient Database (1997, 2000, 2003, and 2006), we identified catheter ablation hospitalizations in patients < 18 years of age. We examined charges over time and used multivariable analysis to identify predictors of increased charges.
Results: There were 5816 hospitalizations for catheter ablation during the 4 sampled years. Mean age at ablation was 12.2 years. Patients with congenital heart disease made up 9% of the sample. Medicaid patients increased from 16% in 1997 to 26% in 2006. Complications occurred in 7% of hospitalizations. Mean total charges (adjusted to 2009 dollars) rose 150%, from $23,798 in 1997 to $59,446 in 2006, compared to an increase of only 47% in the indexed medical care services inflation rate during the same period. Charges for catheter ablation increased markedly relative to other pediatric procedures, but with a similar slope to other catheter-based cardiac interventions. (Figure) Multivariable analysis revealed that year (p<0.0001), length of stay (p<0.0001), congenital heart disease (p=0.0009), atrial flutter (p=0.0079), and cardiac complications (p=0.0019) predicted increased charges. Age, gender, payer, hospital type, hospital volume, and teaching hospital status did not predict increased charges. The overall adjusted R2 value for the model is 0.4555.
Conclusions: Charges for pediatric catheter ablation increased significantly from 1997 to 2006 relative to other pediatric procedures and outstripped the inflation rate for medical services by 103%. Introduction of costly new equipment, such as advanced mapping systems used during ablations in patients with congenital heart disease and atrial flutter, could explain some of the trend.
- © 2011 by American Heart Association, Inc.