A pilot study of expenditures on, and utilization of resources in, health care in adults with congenital heart disease

Moons, Philip; Siebens, Kaat; Geest, Sabina De; Abraham, Ivo; Budts, Werner; Gewillig, Marc

doi:10.1017/s1047951101000336

Cited by 43 publications

(37 citation statements)

References 11 publications

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“…16,26,27 A study by Lee and colleagues 26 revealed that adolescents whose parents overprotect or underestimate them have higher levels of depression. Adolescents' chronic diseases can impose physical, psychologic, and economic burdens on families; these can affect the relationship between adolescents and parents and thus change parental attitudes, becoming either overprotective or hostile toward adolescents.…”

Section: Discussionmentioning

confidence: 99%

“…Adolescents' chronic diseases can impose physical, psychologic, and economic burdens on families; these can affect the relationship between adolescents and parents and thus change parental attitudes, becoming either overprotective or hostile toward adolescents. 16 This, in turn, can cause social and emotional problems in the adolescents themselves, which makes it difficult for them to live with their diseases. 28 The findings of this study show that parental attitude is correlated with both depression and resilience.…”

Section: Discussionmentioning

confidence: 99%

“…The New York Heart Association (NYHA) functional class criteria 15 and CHD functional index 16 were used …”

Section: Methodsmentioning

confidence: 99%

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Factors influencing depression in adolescents with congenital heart disease

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factors influencing depression in adolescents with congenital heart disease

et al. 2009

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“…quent mortality. 17,18 Risk assessment has the potential to assist therapeutic targeting and appropriate resource allocation for ACHD services.…”

Section: Exercise Intolerance Identifies Patients At Risk Of Hospitalmentioning

confidence: 99%

Exercise Intolerance in Adult Congenital Heart Disease

et al. 2005

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Background-Although some patients with adult congenital heart disease (ACHD) report limitations in exercise capacity, we hypothesized that depressed exercise capacity may be more widespread than superficially evident during clinical consultation and could be a means of assessing risk. Methods and Results-Cardiopulmonary exercise testing was performed in 335 consecutive ACHD patients (age, 33Ϯ13 years), 40 non-congenital heart failure patients (age, 58Ϯ15 years), and 11 young (age, 29Ϯ5 years) and 12 older (age, 59Ϯ9 years) healthy subjects. Peak oxygen consumption (peak V O 2 ) was reduced in ACHD patients compared with healthy subjects of similar age (21.7Ϯ8.5 versus 45.1Ϯ8.6; PϽ0.001). No significant difference in peak V O 2 was found between ACHD and heart failure patients of corresponding NYHA class (PϭNS for each NYHA class). Within ACHD subgroups, peak V O 2 gradually declined from aortic coarctation (28.7Ϯ10.4) to Eisenmenger (11.5Ϯ3.6) patients (PϽ0.001). Multivariable correlates of peak V O 2 were peak heart rate (rϭ0.33), forced expiratory volume (rϭ0.33), pulmonary hypertension (rϭϪ0.26), gender (rϭϪ0.23), and body mass index (rϭϪ0.19). After a median follow-up of 10 months, 62 patients (18.5%) were hospitalized or had died. On multivariable Cox analysis, peak V O 2 predicted hospitalization or death (hazard ratio, 0.937; Pϭ0.01) and was related to the frequency and duration of hospitalization (Pϭ0.01 for each). Conclusions-Exercise capacity is depressed in ACHD patients (even in allegedly asymptomatic patients) on a par with chronic heart failure subjects. Lack of heart rate response to exercise, pulmonary arterial hypertension, and impaired pulmonary function are important correlates of exercise capacity, as is underlying cardiac anatomy. Poor exercise capacity identifies ACHD patients at risk for hospitalization or death. (Circulation. 2005;112:828-835.)

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“…Adults with congenital heart disease are complex and have greater comorbidities and higher admission rates compared with the general patient population. [3][4][5][6][7] This complexity often contributes to the increased utilization of health care resources. Despite the important role that pediatric hospitals play in the care of patients with congenital heart disease, resource utilization of adult patients who undergo congenital heart surgery in pediatric hospitals is understudied.…”

mentioning

confidence: 99%

Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals

Kim

Gauvreau

Bacha

et al. 2011

Circ: Cardiovascular Quality and Outcomes

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Background-Pediatric hospitals frequently perform congenital heart surgery in adults with congenital heart disease. The impact of these admissions on pediatric hospital resources is unknown. Our goals were to examine resource use by adults undergoing congenital heart surgery in pediatric hospitals, explore the association between high resource use (HRU) and inpatient death, and identify HRU risk factors. Methods and Results-We obtained inpatient data from 42 pediatric hospitals from 2000 to 2008 and selected adult congenital heart (ACH) surgery admissions. We defined HRU admissions as those exceeding the 90th percentile for total hospital charges. We performed multivariable analyses using generalized estimating equations to identify risk factors for HRU. Of 97 563 congenital heart surgery admissions to pediatric hospitals, 3061 (3.1%) were adults, accounting for 2.2% of total hospital charges.

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A pilot study of expenditures on, and utilization of resources in, health care in adults with congenital heart disease

Cited by 43 publications

References 11 publications

Factors influencing depression in adolescents with congenital heart disease

Factors influencing depression in adolescents with congenital heart disease

Exercise Intolerance in Adult Congenital Heart Disease

Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals

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