{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:06:14Z","timestamp":1782403574917,"version":"3.54.5"},"reference-count":44,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,4,1]]},"abstract":"<jats:p>OBJECTIVES. Teaching hospitals are perceived to provide a higher quality of care for the treatment of rare disease and complex patients. A substantial proportion of stage I palliation for hypoplastic left heart syndrome (HLHS) may be performed in nonteaching hospitals. This study compares the in-hospital mortality of stage I palliation between teaching and nonteaching hospitals.<\/jats:p><jats:p>METHODS. The authors conducted a retrospective cohort study using the Kids' Inpatient Database 1997 and 2000. Patients with HLHS undergoing stage I palliation were identified using International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic and procedural codes.<\/jats:p><jats:p>RESULTS. Seven hundred fifty-four and 880 discharges of children with HLHS undergoing stage I palliation in 1997 and 2000, respectively, were identified. The in-hospital mortality for the study population was 28% in 1997 and 24% in 2000. Twenty percent of stage I palliation operations were performed in nonteaching hospitals in 1997. Two percent of operations were performed in nonteaching hospitals in 2000. In 1997 only, in-hospital mortality remained higher in nonteaching hospitals after controlling for stage I palliation hospital volume and condition-severity diagnoses. Low-volume hospitals performing stage I palliation were associated with increased in-hospital mortality in 1997 and 2000.<\/jats:p><jats:p>CONCLUSIONS. Patients with HLHS undergoing stage I palliation in nonteaching hospitals experienced increased in-hospital mortality in 1997. A significant reduction in the number of stage I palliation procedures performed in nonteaching hospitals occurred between 1997 and 2000. This centralization of stage I palliation into teaching hospitals, along with advances in postoperative medical and surgical care for these children, was associated with a decrease in mortality. Patients in low-volume hospitals performing stage I palliation continued to experience increased mortality in 2000.<\/jats:p>","DOI":"10.1542\/peds.2005-1544","type":"journal-article","created":{"date-parts":[[2006,4,3]],"date-time":"2006-04-03T21:23:11Z","timestamp":1144099391000},"page":"1307-1313","source":"Crossref","is-referenced-by-count":26,"title":["In-Hospital Mortality for Children With Hypoplastic Left Heart Syndrome After Stage I Surgical Palliation: Teaching Versus Nonteaching Hospitals"],"prefix":"10.1542","volume":"117","author":[{"given":"Jay G.","family":"Berry","sequence":"first","affiliation":[{"name":"Harvard Pediatric Health Services Research Fellowship Program, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin G.","family":"Cowley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Primary Children's Medical Center, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles J.","family":"Hoff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Primary Children's Medical Center, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendu","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Primary Children's Medical Center, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,4,1]]},"reference":[{"key":"2021120902164199000_R1","doi-asserted-by":"crossref","unstructured":"Noonan JA, Nadas AS. 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