Key result
Prenatal diagnosis with fetal echocardiography increased significantly over time and did not significantly increase total medical costs for congenital heart disease surgery in recent years.
Why the study?
The rate of prenatal diagnosis of congenital heart disease is increasing with advancing fetal echocardiography techniques, but trends in its use and its impact on treatment medical costs needed investigation.
Does prenatal diagnosis with fetal echocardiography affect medical costs and hospitalization duration in neonates undergoing surgery for congenital heart disease?
Observational (n=375)
No
Does prenatal diagnosis with fetal echocardiography affect medical costs and hospitalization duration in neonates undergoing surgery for congenital heart disease?
Absolute Event Rate: 55966% vs 54224%
p-value: p=0.862
The use of fetal echocardiography for prenatal diagnosis of congenital heart disease has increased significantly over time without increasing the economic burden of hospitalization and medical costs in recent years.
Fetal echocardiography trends may link to lower CHD costs; hypothesis-generating and should not yet change practice.
Background The rate of the prenatal diagnosis of congenital heart disease is increasing along with advances in fetal echocardiography techniques. Here, we aimed to investigate the trend of the use of fetal echocardiography over time and to compare the medical costs of congenital heart disease treatment according to whether fetal echocardiography was performed. Methods We reviewed our hospital’s database, and patients who underwent the first surgery for congenital heart disease within 30 days of birth during 2005–2007, 2011–2013, and 2017–2019 were included. The severity of congenital heart disease diagnosed in each case was evaluated according to The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Mortality Scores (STS-EACTS Mortality Scores) and Mortality Categories (STAT Mortality Categories). Results In total, 375 patients were analyzed, and fetal echocardiography use increased significantly after the 2010s compared with in 2005–2007 (19.1% vs. 39%, p = 0.032 in Mortality Category 1–3; 15.5% vs. 69.5%, p = 0.000 in Mortality Category 4–5). Additionally, the mean STS-EACTS Mortality Score was higher in prenatally diagnosed patients than in postnatally diagnosed patients (2.287 vs. 1.787, p = 0.001). In the recent period, there was no significant difference in hospitalization durations and medical costs according to whether or not fetal echocardiography was performed. Conclusions This single center study showed the use of fetal echocardiography is increasing. Further, prenatal diagnosis with fetal echocardiography causing no differences in medical costs in recent years. Therefore, we suggest that fetal echocardiography can be applied more widely without increasing the economic burden.
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Choi et al. (2023) conducted an observational in Congenital heart disease (n=375). Fetal echocardiography vs. No fetal echocardiography (postnatal diagnosis) was evaluated on Total medical costs ($) for first operation in 2017-2019 (Mortality Category 4-5) (p=0.862). Prenatal diagnosis with fetal echocardiography increased significantly over time and did not significantly increase total medical costs for congenital heart disease surgery in recent years.
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