{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:56:44Z","timestamp":1792040204511,"version":"4.4.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Congenital heart disease consumes significant health care resources; however, there are limited data regarding factors affecting resource utilization. The purpose of this study was to evaluate variation between centers in total hospital costs for 4 congenital heart operations of varying complexity and associated factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              The Premier Database was used to evaluate total cost in children undergoing isolated atrial septal defect (ASD) repair, ventricular septal defect (VSD) repair, tetralogy of Fallot (TOF) repair, or arterial switch operation (ASO) from 2001 to 2007. Mixed models were used to evaluate the impact of center on total hospital costs adjusting for patient and center characteristics and length of stay. A total of 2124 patients were included: 719 ASD (19 centers), 792 VSD (20 centers), 420 TOF (17 centers), and 193 ASO (13 centers). Total cost increased with complexity of operation from median $12 761 (ASD repair) to $55 430 (ASO). In multivariable analysis, models that accounted for center effects versus those that did not performed significantly better for all 4 surgeries (all\n              <jats:italic>P<\/jats:italic>\n              \u22640.01). The proportion of total cost variation explained by center was 19% (ASD repair), 11% (VSD repair), 6% (TOF repair), and 3% (ASO). Higher-volume centers had significantly lower hospital costs for ASD and VSD repair but not for TOF repair and ASO.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Total hospital costs varied significantly by center for all congenital heart surgeries evaluated, even after adjustment for patient and center characteristics and length of stay. Differences among centers were most prominent for lower complexity procedures.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.110.958959","type":"journal-article","created":{"date-parts":[[2011,4,20]],"date-time":"2011-04-20T05:27:15Z","timestamp":1303277235000},"page":"306-312","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":93,"title":["Center Variation in Hospital Costs for Patients Undergoing Congenital Heart Surgery"],"prefix":"10.1161","volume":"4","author":[{"given":"Sara K.","family":"Pasquali","sequence":"first","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie-Lena","family":"Sun","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"d'Almada","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.B.","family":"Jaquiss","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Lodge","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal","family":"Miller","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex R.","family":"Kemper","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole M.","family":"Lannon","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Li","sequence":"additional","affiliation":[{"name":"From the Divisions of Pediatric Cardiology (S.K.P., J.S.L.) and Cardiothoracic Surgery (R.D.B.J., A.J.L.) and the Duke Clinical Research Institute (S.K.P., J.-L.S., P.d'A., N.M., A.R.K., J.S.L.), Duke University Medical Center, Durham, NC; and Department of Pediatrics and Center for Health Care Quality (C.M.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"e23","article-title":"Nationwide trends in inpatient pediatric cardiac surgery and interventional catheterization procedures from 1997\u20132006: on-line estimates from the US Healthcare Cost and Utilization Project","volume":"2","author":"Gray DT","year":"2009","unstructured":"Gray DT, Pourmoghadam K, Weis J, Hsu A, Moore J, Jacobs J, Steiner C, Jacobs M. Nationwide trends in inpatient pediatric cardiac surgery and interventional catheterization procedures from 1997\u20132006: on-line estimates from the US Healthcare Cost and Utilization Project. Circ Cardiovasc Qual Outcomes. 2009;2:e23.","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"e_1_3_3_3_2","first-page":"25","article-title":"Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects-United States, 2003","volume":"56","author":"Robbins JM","year":"2007","unstructured":"Robbins JM, Bird TM, Tilford JM, Cleves MA, Hobbs CA, Grosse SD, Correa A. Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects-United States, 2003. 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The reduction in hospital stay and costs in the care of patients with congenital heart diseases undergoing fast-track cardiac surgery. Arq Bras Cardiol. 2004;83:27\u201334.","journal-title":"Arq Bras Cardiol"},{"key":"e_1_3_3_19_2","first-page":"123","article-title":"Containing costs in the treatment of congenital heart disease","volume":"141","author":"Waldman JD","year":"1984","unstructured":"Waldman JD, George L, Lamberti JJ, Lodge FA, Pappelbaum SJ, Turner SW, Mathewson JW, Kirkpatrick SE. Containing costs in the treatment of congenital heart disease. West J Med. 1984;141:123\u2013126.","journal-title":"West J Med"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2009.00323.x"},{"key":"e_1_3_3_21_2","volume-title":"The Society of Thoracic Surgeons and Duke Clinical Research Institute","author":"Jacobs JP","unstructured":"Jacobs JP, Jacobs ML, Mavroudis C, Lacour-Gayet FG, Tchervenkov CI. Executive Summary: The Society of Thoracic Surgeons Congenital Heart Surgery Database: Twelfth Harvest (January 1, 2006 to December 31, 2009). The Society of Thoracic Surgeons and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. 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