Abstract 20596: Cumulative Hospital-Related Costs Do not Differ Between the Norwood and Hybrid Strategies for Single Ventricle Palliation
Introduction: Limited data exist on the health care costs associated with the Norwood and Hybrid strategies for single ventricle palliation. We compared the cumulative hospital-related costs of patients treated with these two strategies.
Methods: We performed a retrospective analysis of 129 consecutive patients with single ventricle physiology who underwent stage 1 palliation (76 Norwood, 53 Hybrid) between 2007 and 2015 at a tertiary pediatric center. Costs associated with inpatient episodes of care from first admission until death or Fontan completion were retrieved from our institution’s Financial Department. Costs are presented in 2016 US dollars (USD). Costs at each stage of single ventricle palliation were calculated and compared pairwise. The effect of surgical strategy on the cost of repeated hospitalizations over time was assessed using linear mixed model regression.
Results: The median number of hospitalizations per patient was 4 (IQR: 2-6) in the Norwood group versus 5 (IQR: 2-8) in the Hybrid group (p=0.55). The median length of stay per hospitalization was 7 (IQR: 1-24) days in the Norwood group versus 6 (IQR:1-20) days in the Hybrid group (p=0.41). There were 179 admissions in the Norwood group (52%) and 134 in the Hybrid group (49%) that involved at least one surgical intervention (p=0.51). Surgical strategy was not significantly associated with the cost of repeated hospitalizations over time (Figure 1A). The median cumulative cost per patient was $220,804 (IQR $155,432—$400,259) versus $237,798 (IQR $156,064—$455,607) in the Norwood and Hybrid groups, respectively (p=0.65). The hybrid strategy was associated with higher interstage costs (p<0.001) and stage 2 costs (p<0.001) (Figure 1B).
Conclusions: There was no difference in cumulative costs over time during the study period between the Norwood and Hybrid strategies. The higher costs during the interstage and stage 2 in the Hybrid group likely reflect the deferral of more complex intervention.
Author Disclosures: A. Mazine: None. J.M. Meza: None. A. Guerguerian: None. C. Haller: None. S.M. Schwartz: None. B.W. McCrindle: None. G.S. Van Arsdell: None. O. Honjo: None. C.A. Caldarone: None.
- © 2016 by American Heart Association, Inc.