PMID- 28462755
OWN - NLM
STAT- MEDLINE
DCOM- 20180309
LR  - 20181202
IS  - 1467-1107 (Electronic)
IS  - 1047-9511 (Linking)
VI  - 27
IP  - 4
DP  - 2017 May
TI  - A multi-institutional study of factors affecting resource utilisation following 
      the Fontan operation.
PG  - 739-746
LID - 10.1017/S1047951116001244 [doi]
AB  - The few studies evaluating data on resource utilisation following the Fontan 
      operation specifically are outdated. We sought to evaluate resource utilisation 
      and factors associated with increased resource use after the Fontan operation in 
      a contemporary, large, multi-institutional cohort. This retrospective cohort 
      study of children who had the Fontan between January, 2004 and June, 2013 used 
      the Pediatric Health Information Systems Database. Generalised linear regression 
      analyses evaluated factors associated with resource use. Of 2187 Fontan patients 
      included in the study, 62% were males. The median age at Fontan was 3.2 years 
      (inter-quartile range (IQR): 2.6-3.8). The median length of stay following the 
      Fontan was 9 days (IQR: 7-14). The median costs and charges in 2012 dollars for 
      the Fontan operation were $93,900 (IQR: $67,800-$136,100) and $156,000 (IQR: 
      $112,080-$225,607), respectively. Postoperative Fontan mortality (30 days) was 1% 
      (n=21). Factors associated with increased resource utilisation included baseline 
      and demographic factors such as region, race, and renal anomaly, factors at the 
      bidirectional Glenn such as seizures, valvuloplasty, and surgical volume, number 
      of admissions between the bidirectional Glenn and the Fontan, and factors at the 
      Fontan such as surgical volume and age at Fontan. The most strongly associated 
      factors for both increased Fontan length of stay and increased Fontan charges 
      were number of bidirectional Glenn to Fontan admissions (p<0.001) and Fontan 
      surgical volume per year (p<0.001). As patient characteristics and 
      healthcare-related delivery variables accounted for most of the factors 
      predicting increased resource utilisation, changes should target healthcare 
      delivery factors to reduce costs in this resource-intensive population.
FAU - Hinkle, Kevin A
AU  - Hinkle KA
AD  - 1Division of Pediatric Cardiology,Department of Pediatrics,University of 
      Utah,Salt Lake City,Utah,United States of America.
FAU - Wilkes, Jacob
AU  - Wilkes J
AD  - 2Pediatric Clinical Programs,Intermountain Healthcare,Salt Lake City,Utah,United 
      States of America.
FAU - McFadden, Molly
AU  - McFadden M
AD  - 1Division of Pediatric Cardiology,Department of Pediatrics,University of 
      Utah,Salt Lake City,Utah,United States of America.
FAU - Williams, Richard V
AU  - Williams RV
AD  - 1Division of Pediatric Cardiology,Department of Pediatrics,University of 
      Utah,Salt Lake City,Utah,United States of America.
FAU - Minich, LuAnn L
AU  - Minich LL
AD  - 1Division of Pediatric Cardiology,Department of Pediatrics,University of 
      Utah,Salt Lake City,Utah,United States of America.
FAU - Menon, Shaji C
AU  - Menon SC
AD  - 1Division of Pediatric Cardiology,Department of Pediatrics,University of 
      Utah,Salt Lake City,Utah,United States of America.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Cardiol Young
JT  - Cardiology in the young
JID - 9200019
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Fontan Procedure/*economics/*mortality
MH  - Health Resources/statistics & numerical data
MH  - Heart Ventricles/abnormalities/surgery
MH  - *Hospital Costs
MH  - Humans
MH  - Hypoplastic Left Heart Syndrome/*surgery
MH  - Infant
MH  - *Length of Stay
MH  - Linear Models
MH  - Male
MH  - Palliative Care
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - United States
OTO - NOTNLM
OT  - CHD
OT  - Fontan
OT  - resource utilisation
EDAT- 2017/05/04 06:00
MHDA- 2018/03/10 06:00
CRDT- 2017/05/03 06:00
PHST- 2017/05/03 06:00 [entrez]
PHST- 2017/05/04 06:00 [pubmed]
PHST- 2018/03/10 06:00 [medline]
AID - S1047951116001244 [pii]
AID - 10.1017/S1047951116001244 [doi]
PST - ppublish
SO  - Cardiol Young. 2017 May;27(4):739-746. doi: 10.1017/S1047951116001244.