{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T03:41:25Z","timestamp":1771472485571,"version":"3.50.1"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite excellent operative survival, correction of tetralogy of Fallot frequently is accompanied by residual lesions that may affect health beyond the incident hospitalization. Measuring resource utilization, specifically cost and length of stay, provides an integrated measure of morbidity not appreciable in traditional outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We conducted a retrospective cohort study, using de\u2010identified commercial insurance claims data, of 269 children who underwent operative correction of tetralogy of Fallot from January 2004 to September 2015 with \u22652\u00a0years of continuous follow\u2010up (1) to describe resource utilization for the incident hospitalization and subsequent 2\u00a0years, (2) to determine whether prolonged length of stay (&gt;7\u00a0days) in the incident hospitalization was associated with increased subsequent resource utilization, and (3) to explore whether there was regional variation in resource utilization with both direct comparisons and multivariable models adjusting for known covariates. Subjects with prolonged incident hospitalization length of stay demonstrated greater resource utilization (total cost as well as counts of outpatient visits, hospitalizations, and catheterizations) after hospital discharge (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001 for each), though the number of subsequent operative and transcatheter interventions were not significantly different. Regional differences were observed in the cost of incident hospitalization as well as subsequent hospitalizations, outpatient visits, and the costs associated with each.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This study is the first to report short\u2010 and medium\u2010term resource utilization following tetralogy of Fallot operative correction. It also demonstrates that prolonged length of stay in the initial hospitalization is associated with increased subsequent resource utilization. This should motivate research to determine whether these differences are because of modifiable factors.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016581","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T09:03:57Z","timestamp":1595322237000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Resource Utilization in the First 2 Years Following Operative Correction for Tetralogy of Fallot: Study Using Data From the Optum's De\u2010Identified Clinformatics Data Mart Insurance Claims Database"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-1634","authenticated-orcid":false,"given":"Michael L.","family":"O'Byrne","sequence":"first","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"},{"name":"Center for Pediatric Clinical Effectiveness The Children\u2019s Hospital of Philadelphia PA"},{"name":"Leonard Davis Institute and Center for Cardiovascular Outcomes, Quality, and Evaluative Research University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"DeCost","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Katcoff","sequence":"additional","affiliation":[{"name":"Center for Pediatric Clinical Effectiveness The Children\u2019s Hospital of Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill J.","family":"Savla","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce","family":"Chang","sequence":"additional","affiliation":[{"name":"Center for Pediatric Clinical Effectiveness The Children\u2019s Hospital of Philadelphia PA"},{"name":"Division of Rheumatology The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Goldmuntz","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter W.","family":"Groeneveld","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"},{"name":"Corporal Michael J. 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