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Centre variation in cost and outcomes for congenital heart surgery*

Published online by Cambridge University Press:  18 January 2013

Sara K. Pasquali ,
Michael G. Gaies ,
Jeffrey P. Jacobs ,
J. William Gaynor  and
Marshall L. Jacobs
Sara K. Pasquali*
Affiliation:
Department of Pediatrics and Communicable Diseases, C. S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
Michael G. Gaies
Affiliation:
Department of Pediatrics and Communicable Diseases, C. S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
Jeffrey P. Jacobs
Affiliation:
Division of Thoracic and Cardiovascular Surgery, All Children's Hospital, Saint Petersburg, Florida, United States of America
J. William Gaynor
Affiliation:
Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Marshall L. Jacobs
Affiliation:
Department of Pediatric and Congenital Heart Surgery, Cleveland Clinic, Cleveland, Ohio, United States of America
*
Correspondence to: Dr S. K. Pasquali, MD, MHS, Department of Pediatrics and Communicable Diseases, C. S. Mott Children's Hospital, University of Michigan Congenital Heart Center, 1540 E. Hospital Drive 11-715Z, Ann Arbor, MI 48109-4204, United States of America. Tel: 734 936 7418; Fax: 734-936-9470; E-mail: pasquali@med.umich.edu
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Abstract

Although overall outcomes for children undergoing heart surgery have improved, there is a significant variation in outcomes across hospitals. This review discusses the variation in cost and outcomes across centres performing congenital heart surgery, potential underlying mechanisms, and efforts to reduce variation and improve outcome.

Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 6: A Lifelong Interdisciplinary Approach to Common Arterial Trunk, Transposition of the Great Arteries, and Other Evolving Challenges in Paediatric and Congenital Cardiac Disease , December 2012 , pp. 796 - 799
Copyright
Copyright © Cambridge University Press 2012

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Footnotes

*

Presented at: The Children's Hospital of Philadelphia Cardiology 2012, 16th Annual Update on Pediatric and Congenital Cardiovascular Disease, Orlando, Florida, February 22–26, 2012.

References

1. Jacobs, JP. Executive Summary: The Society of Thoracic Surgeons Congenital Heart Surgery Database – Fourteenth Harvest. The Society of Thoracic Surgeons and Duke Clinical Research Institute, Durham, NC, 2011.Google Scholar
2. Jacobs, JP, O'Brien, SM, Pasquali, SK, et al. Variation in outcomes for benchmark operations: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg 2011; 92: 2184–2192.Google Scholar
3. Pasquali, SK, Ohye, RG, Lu, M, et al. for the Pediatric Heart Network Investigators.Variation in perioperative care across centers for infants undergoing the Norwood procedure. J Thorac Cardiovasc Surg 2012; 144: 915–921.Google Scholar
4. Jacobs, JP, O'Brien, SM, Pasquali, SK, et al. Variation in outcomes for risk-stratified pediatric cardiac surgical operations: an analysis of the society of thoracic surgeons congenital heart surgery database. Ann Thorac Surg 2012; 94: 564–571.CrossRefGoogle Scholar
5. O'Brien, SM, Clarke, DR, Jacobs, JP, et al. An empirically based tool for analyzing mortality associated with congenital heart surgery. J Thorac Cardiovasc Surg 2009; 138: 1139–1153.CrossRefGoogle ScholarPubMed
6. Robbins, JM, Bird, TM, Tilford, JM, et al. Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects – United States, 2003. Morb Mortal Wkly Rep 2007; 56: 25–29.Google Scholar
7. Pasquali, SK, Sun, JL, d'Almada, P, et al. Center variation in hospital costs for patients undergoing congenital heart surgery. Circ Cardiovasc Qual Outcomes 2011; 1: 306–312.Google Scholar
8. Connor, JA, Gauvreau, K, Jenkins, KJ. Factors associated with increased resource utilization for congenital heart disease. Pediatrics 2005; 116: 689–695.Google Scholar
9. Parrish, MD, Pollock, M, Gauthier, N, Park, J, Hobde, B. Sources of variability in hospital costs of atrial septal defect repair. Am J Cardiol 1998; 82: 252–254.Google Scholar
10. Pasquali, SK, He, X, Jacobs, JP, Jacobs, ML, O'Brien, SM, Gaynor, JW. Evaluation of failure to rescue as a quality metric in pediatric heart surgery. Ann Thorac Surg 2012; 94: 573–579.Google Scholar
11. Ghaferi, AA, Birkmeyer, JD, Dimick, JB. Variation in hospital mortality associated with inpatient surgery. New Engl J Med 2009; 361: 1368–1375.Google Scholar
12. Silber, JH, Williams, SV, Krakauer, H, Schwartz, JS. Hospital and patient characteristics associated with death after surgery: a study of adverse occurrence and failure to rescue. Med Care 1992; 30: 615–629.Google Scholar
13. National Quality Forum. Measuring Performance. http://www.qualityforum.org/Measures_List.aspx#k=failure%2520to%2520rescue&e=1&p=2. Accessed August 1, 2012.Google Scholar
14. Wernovsky, G, Ghanayem, N, Ohye, RG, et al. Hypoplastic left heart syndrome: consensus and controversies in 2007. In: Anderson RH, Jacobs JP, Wernovsky G (eds). 2007 Supplement to Cardiology in the Young: Controversies and Challenges Facing Paediatric Cardiovascular Practitioners and their Patients. Cardiol Young. 2007; 17(Suppl 2): 75–86; doi:10.1017/S1047951107001187.Google Scholar
15. Burstein, D, Rossi, A, Jacobs, J, et al. Variation in models of care delivery for children undergoing congenital heart surgery in the United States. World J Pediatr Congenit Heart Surg 2010; 1: 8–14.CrossRefGoogle ScholarPubMed
16. Baker-Smith, CM, Neish, SR, Klitzner, TS, et al. Variation in postoperative care following stage I palliation for single-ventricle patients: a report from the Joint Council on Congenital Heart Disease National Quality Improvement Collaborative. Congenit Heart Dis 2011; 6: 116–127.Google Scholar
17. Burstein, DS, Jacobs, JP, Sheng, S, et al. Care models in congenital heart surgery and associated outcomes. Pediatrics 2011; 127: e1482–e1489.Google Scholar
18. Scheurer, M, Gauvreau, K, Laussen, PC, Mayer, JE, Atz, AM, Newburger, JW. The impact of a designated cardiac intensive care unit on outcomes after the Norwood procedure. J Am Coll Cardiol 2011; 57: E405.CrossRefGoogle Scholar
19. Pasquali, SK, Li, JS, Burstein, DB, et al. The association of center volume with mortality and complications in pediatric heart surgery. Pediatrics 2012; 129: e370–e376.Google Scholar
20. Hornik, CP, He, X, Jacobs, JP, et al. Relative impact of surgeon and center volume on early mortality following the Norwood operation. Ann Thorac Surg 2012; 93: 1992–1997.CrossRefGoogle Scholar
21. Welke, KF, O'Brien, SM, Peterson, ED, et al. The complex relationship between pediatric cardiac surgical case volumes and mortality rates in a national clinical database. J Thorac Cardiovasc Surg 2009; 137: 1133–1140.Google Scholar
22. Prager, RL, Armenti, FR, Bassett, JS, et al. Cardiac Surgeons and the quality movement: the Michigan experience. Semin Thorac Cardiovasc Surg 2009; 21: 20–27.CrossRefGoogle ScholarPubMed
23. Likosky, DS. Lessons learned from the Northern New England Cardiovascular Disease Study Group. Prog Pediatr Cardiol 2012; 33: 53–56.Google Scholar
24. Schidlow, DN, Anderson, JB, Klitzner, TS, et al. Variation in interstage outpatient care after the Norwood procedure: a report from the Joint Council on Congenital Heart Disease National Quality Improvement Collaborative. Congenit Heart Dis 2011; 6: 98–107.CrossRefGoogle ScholarPubMed
25. Chang, RR, Klitzner, TS. Can regionalization decrease the number of deaths for children who undergo cardiac surgery? A theoretical analysis. Pediatrics 2002; 109: 173–181.CrossRefGoogle ScholarPubMed
26. Lundstrom, NR, Berggren, H, Bjorkhem, G, Jogi, P, Sunnegardh, J. Centralization of pediatric heart surgery in Sweden. Pediatr Cardiol 2000; 21: 353–357.Google Scholar
27. Porter, ME. What is value in health care? N Engl J Med 2010; 363: 2477–2481.CrossRefGoogle ScholarPubMed
28. Pasquali, SK, Jacobs, JP, Shook, GJ, et al. Linking clinical registry data with administrative data using indirect identifiers: implementation and validation in the congenital heart surgery population. Am Heart J 2010; 160: 1099–1104.Google Scholar