The Contribution of Complications to High Resource Utilization during Congenital Heart Surgery Admissions

BACKGROUND: The Institutes of Medicine estimates that patient safety events cost the United States between 17 billion and 29 billion annually. Costs associated with patient safety events or complications among congenital heart surgery admissions are understudied. OBJECTIVE: To determine the independent contribution of complications on increased resource utilization during congenital heart surgery admissions. DESIGN/METHODS: Data were obtained from the Healthcare Cost and Utilization Project Kids' Inpatient Database year 2000. Cases of congenital heart surgery or=192, 272. High resource admissions accounted for >40% of the total charges for all admissions. Complications were identified in 3360 (32%) of congenital heart surgery admissions. Univariate analysis demonstrated that admissions with at least 1 complication diagnosis were more likely to be a high resource use admission (18% vs. 6%, OR 3. 0, P < 0. 001). Multivariate analyses revealed that admissions with a complication diagnosis were much more likely to exceed the threshold for high resource utilization (OR 3. 2, P < 0. 001). The addition of the complication variable to the multivariate model increased the area under the ROC curve from 0. 837 to 0. 863. CONCLUSIONS: Congenital heart surgery admissions with a complication diagnosis are 3 times more likely to exceed 192 272 in total charges despite adjusting for known risk factors for high resource use. Complication reduction may result in both an economic and clinical benefit.