{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:22:51Z","timestamp":1789611771497,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009110","name":"Natural Science Foundation of Xinjiang Uygur Autonomous Region","doi-asserted-by":"publisher","award":["2022D01C707\u53f7"],"award-info":[{"award-number":["2022D01C707\u53f7"]}],"id":[{"id":"10.13039\/100009110","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to identify key determinants of hospitalization costs for children aged 0\u201314 years with congenital heart disease (CHD) at a tertiary hospital in Xinjiang, China, to provide evidence for reducing the financial burden on families and improving health insurance policies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of medical records from 2,811 pediatric patients who underwent CHD surgery between September 2013 and September 2024. Potential influencing factors were screened using non-parametric tests, and mediating effects were examined through the Bias-Corrected Bootstrap method with 5,000 repetitions. Path analysis modeling was performed with AMOS 24.0 to clarify direct and indirect pathways among variables affecting hospitalization costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median hospitalization costs for CHD patients showed an initial increase followed by a progressive decline, with sustained reduction after 2019. Costs for open-heart surgery consistently exceeded those for interventional procedures, with the former dominated by treatment fees and the latter primarily composed of material costs. Several factors were significantly associated with higher costs, including age under 2 years, absence of health insurance, complex CHD, open-heart surgery, and hospital stays lasting 20 days or longer (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Path analysis indicated that older age (\u03b2 = \u22120.047) indirectly reduced costs through the \u201ctreatment approach \u2192 length of stay\u201d pathway. In contrast, both disease type (\u03b2 = 0.087) and severity (\u03b2 = 0.061) demonstrated positive indirect effects along the same pathway. Health insurance (\u03b2 = \u22120.045) contributed to cost reduction indirectly through its association with shorter hospitalization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multiple clinical and socioeconomic factors influence hospitalization costs for children with CHD. To minimize the risk of catastrophic health expenditures for families, we recommend prioritizing interventional procedures, optimizing insurance reimbursement strategies, and enhancing awareness and enrollment in neonatal health insurance programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1714957","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:20:41Z","timestamp":1768206041000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of hospitalization expenditure for pediatric congenital heart disease: a single-center study from Xinjiang, China"],"prefix":"10.3389","volume":"13","author":[{"given":"Lizha","family":"Jiangabieke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azhamati","family":"Azhati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiling","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1146\/annurev-med-050922-052324","article-title":"Complex congenital heart disease in the adult","volume":"75","author":"Goldstein","year":"2024","journal-title":"Annu Rev Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Abbafati","year":"2020","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/S2352-4642(19)30402-X","article-title":"Global, regional, and national burden of congenital heart disease, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"4","author":"GBD","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990\u20132019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/S2352-4642(23)00051-2","article-title":"Current status and challenges in prenatal and neonatal screening, diagnosis, and management of congenital heart disease in China","volume":"7","author":"Zhang","year":"2023","journal-title":"Lancet Child Adolesc Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.3760\/j.issn.1673-4777.2020.08.001","article-title":"The significant contribution of tertiary prevention and treatment of congenital heart disease to promoting public health and supporting the comprehensive well-off society","volume":"15","author":"Liu","year":"2020","journal-title":"Chin Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2323","DOI":"10.1016\/j.athoracsur.2021.11.017","article-title":"Assessment of current society of thoracic surgeons data elements for adults with congenital heart disease","volume":"114","author":"Nelson","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/S1010-7940(99)00137-2","article-title":"Twenty-to-thirty-seven-year follow-up after repair for tetralogy of fallot","volume":"16","author":"N\u00f8rgaard","year":"1999","journal-title":"Eur J Cardiothorac Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1056\/NEJM199012133232401","article-title":"Long-term outcome after surgical repair of isolated atrial septal defect. 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