{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:18:53Z","timestamp":1787822333787,"version":"build-2784847793"},"reference-count":63,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["NU50DD000102"],"award-info":[{"award-number":["NU50DD000102"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007305","name":"Maternal and Child Health Bureau","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007305","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Children with birth defects often require complex medical care, contributing to increased healthcare costs. Understanding the economic burden of birth defects is important for resource planning, but recent Texas\u2010specific data are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective data analysis was conducted using the Texas Hospital Inpatient Discharge Public Use Data File (PUDF) for all pediatric discharges (ages 0\u201317\u2009years) documented between 2021 and 2023. We identified hospitalizations with birth defects based on the presence of an ICD\u201010 code (Q00\u2010Q99) in any of the 26 diagnosis code fields. Median inflation\u2010adjusted hospitalization charges were calculated for hospitalizations with and without birth defects and were then stratified by characteristics of interest. Median charges were compared using the Wilcoxon\u2010rank sum test. Among hospitalizations of children with a birth defect in the principal diagnosis code field, charges were examined by birth defect phenotype. A sub\u2010analysis assessed charges for hospitalizations that occurred primarily in the Intensive Care Unit (ICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In Texas, 12.5% of all pediatric hospitalizations were for children with a birth defect. Aggregate total charges for these hospitalizations exceeded $26\u2009billion and comprised 34.9% of all pediatric hospitalization charges. Hospitalizations for children with a birth defect had significantly higher median charges ($12,876 vs. $7,813) compared to hospitalizations for children without birth defects (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Higher charges were observed for hospitalizations among several subgroups (e.g., ICU hospitalizations).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Inpatient hospitalization charges for children with birth defects had a disproportionately high impact on hospitalization charges in Texas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.70098","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T03:02:59Z","timestamp":1786071779000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inpatient Hospitalization Charges for Children With Birth Defects in Texas, 2021\u20132023"],"prefix":"10.1002","volume":"118","author":[{"given":"Dayana","family":"Betancourt","sequence":"first","affiliation":[{"name":"Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-2835","authenticated-orcid":false,"given":"Charles","family":"Shumate","sequence":"additional","affiliation":[{"name":"Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henal","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0633-8013","authenticated-orcid":false,"given":"Rachel","family":"Allred","sequence":"additional","affiliation":[{"name":"Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlyn","family":"Yantz","sequence":"additional","affiliation":[{"name":"Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0077-6023","authenticated-orcid":false,"given":"Jason","family":"Salemi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health University of South Florida Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-4155","authenticated-orcid":false,"given":"A. J.","family":"Agopian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Texas Health Science Center at Houston, School of Public Health Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2011.07.026"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6602a1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.1414"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0986"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdr054"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010020\u201005409\u2010w"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.2486"},{"key":"e_1_2_9_9_1","unstructured":"Centers for Medicare and Medicaid Services.2013.\u201cManaged Care in Texas.\u201dAccessed October 10 2025.https:\/\/www.medicaid.gov\/Medicaid\/downloads\/texas\u2010mcp.pdf."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004\u20102071"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u2010041723"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23295"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010\u20103742"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2013.06.022"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12612"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.8.FOCUS16257"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018286"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.07.062"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010publhealth\u2010040119\u2010094345"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxad001"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2017.04.012"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.05.016"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2019.02.007"},{"key":"e_1_2_9_24_1","unstructured":"Health and Human Services.2022.\u201cWho's Eligible for Medicare.\u201dRetrieved April 29 2026 from.https:\/\/www.hhs.gov\/answers\/medicare\u2010and\u2010medicaid\/who\u2010is\u2010eligible\u2010for\u2010medicare\/index.html."},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.05.100"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1809"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12613"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2019.01.007"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.14334"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2023.0184"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000009863"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246\u2010023\u201003372\u2010x"},{"key":"e_1_2_9_33_1","unstructured":"Legislative Budget Board Staff.2019.\u201cImprove Operation of the STAR Kids Program.\u201dAccessed October 10 2025.www.lbb.state.tx.us\/documents\/publications\/staff_report\/2019\/4743_star_kids.pdf."},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz009"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.29885"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100042\u20101755458"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.12.117"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.5337"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23470"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102023\u2010326557"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246\u2010013\u20100788\u2010z"},{"key":"e_1_2_9_42_1","doi-asserted-by":"crossref","unstructured":"Osterman M. 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American Community Survey ACS 1\u2010Year Estimates Subject Tables Table\u00a0S1901.\u201dRetrieved April 25 2026 from.https:\/\/data.census.gov\/table\/ACSST1Y2024.S1901?q=median+household+income+texas&g=040XX00US48."},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022\u2010058756"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2002.11927848"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390\u2010022\u201002008\u20109"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431\u2010011\u20101492\u20108"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.70098","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bdr2.70098","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.70098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:27:35Z","timestamp":1787819255000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.70098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":63,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/bdr2.70098"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.70098","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70098"}}