Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthood
Background: Improvements in diagnosis, intervention, and care of congenital heart disease (CHD) have led to increased survivability and lifelong dependence on healthcare. This study aims to determine the extensiveness of inpatient care episodes across different life-stages and CHD severity compared...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | International Journal of Cardiology Congenital Heart Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666668523000022 |
| _version_ | 1811154714085031936 |
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| author | Salma Pardhan Zacharias Mandalenakis Kok Wai Giang Maria Fedchenko Peter Eriksson Mikael Dellborg |
| author_facet | Salma Pardhan Zacharias Mandalenakis Kok Wai Giang Maria Fedchenko Peter Eriksson Mikael Dellborg |
| author_sort | Salma Pardhan |
| collection | DOAJ |
| description | Background: Improvements in diagnosis, intervention, and care of congenital heart disease (CHD) have led to increased survivability and lifelong dependence on healthcare. This study aims to determine the extensiveness of inpatient care episodes across different life-stages and CHD severity compared to matched controls, and to explore how healthcare utilization among pediatric CHD cases have changed over time. Methodology: National registry data was used to conduct a 1:9 matching analysis with age and sex matched controls. Then, Poisson timeseries analysis was used to conduct trend analysis for inpatient healthcare utilization among pediatric cases <18 years of age. Results: Most CHD cases were non-complex (87.3%), with highest hospitalization rates occurring in infancy. Mean number of hospitalizations among complex cases were over twice that of non-complex cases. Also, as age progressed, mean hospitalization for non-complex cases began converging to the control population. In terms of trend analysis within this study period, healthcare utilization increased by 34% among the infant categories, but decreased by 12% and 32% among children between 1-9 years and 10–17 years, respectively. Also, utilization was not trending in one direction substantiating the claim that multiple time periods are required to assess temporal changes within this population. Conclusion: Inpatient healthcare utilization among the CHD population appears to be decreasing over time in most cases, where non-complex cases transitioning to adult care are increasingly converging to the general population. Additionally, this study validates the need to use multiple time-periods when conducting longitudinal studies across the CHD population. |
| first_indexed | 2024-04-10T04:20:37Z |
| format | Article |
| id | doaj.art-5f9ba6bace70434a8f29e94a1571ebdc |
| institution | Directory Open Access Journal |
| issn | 2666-6685 |
| language | English |
| last_indexed | 2024-04-10T04:20:37Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj.art-5f9ba6bace70434a8f29e94a1571ebdc2023-03-11T04:20:48ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852023-03-0111100440Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthoodSalma Pardhan0Zacharias Mandalenakis1Kok Wai Giang2Maria Fedchenko3Peter Eriksson4Mikael Dellborg5Institute of Health and Care Sciences, University of Gothenburg, Sweden; Department of Biomedical Sciences, KU Leuven, Belgium; Corresponding author. Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademin vid Göteborgs universitet, Box 457, 405 30 Göteborg, Sweden.Adult Congenital Heart Unit, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Medicine, Geriatrics and Emergency Medicine, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Medicine, Geriatrics and Emergency Medicine, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Medicine, Geriatrics and Emergency Medicine, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, SwedenAdult Congenital Heart Unit, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Medicine, Geriatrics and Emergency Medicine, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Medicine, Geriatrics and Emergency Medicine, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, SwedenBackground: Improvements in diagnosis, intervention, and care of congenital heart disease (CHD) have led to increased survivability and lifelong dependence on healthcare. This study aims to determine the extensiveness of inpatient care episodes across different life-stages and CHD severity compared to matched controls, and to explore how healthcare utilization among pediatric CHD cases have changed over time. Methodology: National registry data was used to conduct a 1:9 matching analysis with age and sex matched controls. Then, Poisson timeseries analysis was used to conduct trend analysis for inpatient healthcare utilization among pediatric cases <18 years of age. Results: Most CHD cases were non-complex (87.3%), with highest hospitalization rates occurring in infancy. Mean number of hospitalizations among complex cases were over twice that of non-complex cases. Also, as age progressed, mean hospitalization for non-complex cases began converging to the control population. In terms of trend analysis within this study period, healthcare utilization increased by 34% among the infant categories, but decreased by 12% and 32% among children between 1-9 years and 10–17 years, respectively. Also, utilization was not trending in one direction substantiating the claim that multiple time periods are required to assess temporal changes within this population. Conclusion: Inpatient healthcare utilization among the CHD population appears to be decreasing over time in most cases, where non-complex cases transitioning to adult care are increasingly converging to the general population. Additionally, this study validates the need to use multiple time-periods when conducting longitudinal studies across the CHD population.http://www.sciencedirect.com/science/article/pii/S2666668523000022Congenital heart diseaseInpatient careLife-coursePediatricPrevalenceUtilization |
| spellingShingle | Salma Pardhan Zacharias Mandalenakis Kok Wai Giang Maria Fedchenko Peter Eriksson Mikael Dellborg Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthood International Journal of Cardiology Congenital Heart Disease Congenital heart disease Inpatient care Life-course Pediatric Prevalence Utilization |
| title | Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthood |
| title_full | Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthood |
| title_fullStr | Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthood |
| title_full_unstemmed | Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthood |
| title_short | Healthcare consumption in congenital heart disease: A temporal life-course perspective following pediatric cases to adulthood |
| title_sort | healthcare consumption in congenital heart disease a temporal life course perspective following pediatric cases to adulthood |
| topic | Congenital heart disease Inpatient care Life-course Pediatric Prevalence Utilization |
| url | http://www.sciencedirect.com/science/article/pii/S2666668523000022 |
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