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Cost utility congenital heart disease

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https://www.readbyqxmd.com/read/27855985/can-time-averaged-flow-boundary-conditions-be-used-to-meet-the-clinical-timeline-for-fontan-surgical-planning
#1
Zhenglun Alan Wei, Phillip M Trusty, Mike Tree, Christopher M Haggerty, Elaine Tang, Mark Fogel, Ajit P Yoganathan
Cardiovascular simulations have great potential as a clinical tool for planning and evaluating patient-specific treatment strategies for those suffering from congenital heart diseases, specifically Fontan patients. However, several bottlenecks have delayed wider deployment of the simulations for clinical use; the main obstacle is simulation cost. Currently, time-averaged clinical flow measurements are utilized as numerical boundary conditions (BCs) in order to reduce the computational power and time needed to offer surgical planning within a clinical time frame...
November 10, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27634029/short-term-costs-and-hospitalization-rates-in-patients-with-adult-congenital-heart-disease-after-pulmonic-valve-replacement
#2
Deana Mikhalkova, Eric Novak, Ari Cedars
In the adult congenital heart disease (ACHD) population, pulmonary valve replacement (PVR) is a common intervention, its benefit, however, has been incompletely investigated. This study investigates short- and intermediate-term outcomes after PVR in ACHD. Using State Inpatient Databases from the Healthcare Cost and Utilization Project, we investigated both hospitalization rate and financial burden accrued over the 12-month period after PVR compared with the 12 months before. Among 202 patients who underwent PVR, per patient-year hospitalization rates doubled in the year after PVR compared with the year before (0...
August 22, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27476099/health-care-costs-for-adults-with-congenital-heart-disease-in-the-united-states-2002-to-2012
#3
David A Briston, Elisa A Bradley, Aarthi Sabanayagam, Ali N Zaidi
More adults than children with congenital heart disease (CHD) are alive today. Few studies have evaluated adult congenital heart disease (ACHD) health care utilization in the United States. Data from the National Inpatient Sample from 2002 to 2012, using International Classification of Diseases, Ninth Revision, codes for moderate and complex CHD were analyzed. Hospital discharges, total billed and reimbursed amounts, length of stay, and gender/age disparities were evaluated. There was an increase in CHD discharges (moderate CHD: 4,742 vs 6,545; severe CHD: 807 vs 1,115) and total billed and reimbursed dollar amounts across all CHD (billed: $2...
August 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27471092/bench-and-initial-preclinical-results-of-a-novel-8-mm-diameter-double-opposed-helical-biodegradable-stent
#4
Carrie E Herbert, Surendranath Veeram Reddy, Tré R Welch, Jian Wang, James A Richardson, Joseph M Forbess, Alan W Nugent
BACKGROUND: Metallic endovascular stents are utilized off-label in congenital heart disease. Biodegradable stents (BDS) offer potential advantages in a growing child. We have previously reported double opposed helical (DH) BDS up to 6 mm diameter (DH-6). The objectives are to investigate the bench characteristics of larger 8 mm diameter BDS (DH-8) manufactured with increasing strut thicknesses and the inflammatory profile in a porcine model. METHODS: DH-8 were manufactured with strut thicknesses 0...
July 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27435587/use-of-dofetilide-in-adult-patients-with-atrial-arrhythmias-and-congenital-heart-disease-a-paces-collaborative-study
#5
Iqbal El-Assaad, Sadeer G Al-Kindi, JoEllyn Abraham, Shubhayan Sanatani, David J Bradley, Colby Halsey, Ian H Law, Seshadri Balaji, Ira Shetty, Peter F Aziz
BACKGROUND: Arrhythmia management has become the major treatment challenge in adult patients with congenital heart disease (ACHD). OBJECTIVE: We sought to investigate the utility and safety profile of dofetilide for atrial arrhythmias in ACHD. METHODS: A retrospective chart review was performed. We included patients (age ≥18 years) with congenital heart disease who had atrial fibrillation (AF) or intra-atrial reentrant tachycardia treated with dofetilide...
October 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27291967/risk-factors-for-increased-hospital-resource-utilization-and-in-hospital-mortality-in-adults-with-single-ventricle-congenital-heart-disease
#6
Ronnie Thomas Collins, Pratik Doshi, Jennifer Onukwube, Ricki Y Fram, James M Robbins
Most patients with single ventricle congenital heart disease are now expected to survive to adulthood. Co-morbid medical conditions (CMCs) are common. We sought to identify risk factors for increased hospital resource utilization and in-hospital mortality in adults with single ventricle. We analyzed data from the 2001 to 2011 Nationwide Inpatient Sample database in patients aged ≥18 years admitted to nonteaching general hospitals (NTGHs), TGHs, and pediatric hospitals (PHs) with either hypoplastic left heart syndrome, tricuspid atresia or common ventricle...
August 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27207997/development-and-validation-of-an-agency-for-healthcare-research-and-quality-indicator-for-mortality-after-congenital-heart-surgery-harmonized-with-risk-adjustment-for-congenital-heart-surgery-rachs-1-methodology
#7
Kathy J Jenkins, Jennifer Koch Kupiec, Pamela L Owens, Patrick S Romano, Jeffrey J Geppert, Kimberlee Gauvreau
BACKGROUND: The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by the Agency for Healthcare Research and Quality (AHRQ). Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies. METHODS AND RESULTS: Parameters that were identical between the 2 methods were retained...
May 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27104489/expected-probability-of-congenital-heart-disease-and-clinical-utility-of-fetal-echocardiography-in-pregnancies-with-pre-gestational-diabetes
#8
Ahmed A Nassr, Sherif A El-Nashar, Sherif A Shazly, Wendy M White, Brian C Brost
OBJECTIVES: To establish a prediction model for fetal congenital heart disease (CHD) that could facilitate selective fetal echocardiography screening for diabetic women, and to provide cost analysis of selective versus global screening of these women. STUDY DESIGN: A historical cohort study included women with pre-gestational diabetes who received perinatal care at Mayo Clinic, Minnesota from 2007 through 2013. Anatomical scans and fetal echocardiograms were reviewed and charts for postnatal outcomes were abstracted...
June 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27099971/association-of-hospital-structure-and-complications-with-mortality-after-pediatric-extracorporeal-membrane-oxygenation
#9
Viviane G Nasr, David Faraoni, James A DiNardo, Ravi R Thiagarajan
OBJECTIVES: Extracorporeal membrane oxygenation is increasingly utilized to provide cardiopulmonary support to critically ill children. Although life-saving in many instances, extracorporeal membrane oxygenation support is associated with considerable morbidity and mortality. This study evaluates the effect of extracorporeal membrane oxygenation complications and extracorporeal membrane oxygenation hospital characteristics on mortality in neonates and children supported with extracorporeal membrane oxygenation...
July 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27033018/3d-printing-to-guide-ventricular-assist-device-placement-in-adults-with-congenital-heart-disease-and-heart-failure
#10
REVIEW
Kanwal M Farooqi, Omar Saeed, Ali Zaidi, Javier Sanz, James C Nielsen, Daphne T Hsu, Ulrich P Jorde
As the population of adults with congenital heart disease continues to grow, so does the number of these patients with heart failure. Ventricular assist devices are underutilized in adults with congenital heart disease due to their complex anatomic arrangements and physiology. Advanced imaging techniques that may increase the utilization of mechanical circulatory support in this population must be explored. Three-dimensional printing offers individualized structural models that would enable pre-surgical planning of cannula and device placement in adults with congenital cardiac disease and heart failure who are candidates for such therapies...
April 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27018934/resource-utilization-for-noncardiac-admissions-in-pediatric-patients-with-single-ventricle-disease
#11
Ian D Thomas, Michael D Seckeler
Patients with single ventricle (SV) congenital heart disease (CHD) incur high hospital costs during staged surgical palliation. Health care resource utilization for noncardiac admissions in patients with SV has not been reported. This study sought to compare costs and outcomes for common noncardiac hospital admissions between patients with SV and patients without CHD. Hospital discharge data from the University Health System Consortium from January 2011 to December 2013 was queried for patients aged ≤18 years with International Classification of Diseases, Ninth Revision (ICD-9) codes for SV lesions: hypoplastic left heart syndrome (746...
May 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/26990189/evaluation-of-high-resolution-melting-for-mthfr-c677t-genotyping-in-congenital-heart-disease
#12
Ying Wang, Haiyan Zhang, Shuying Yue, Kun Zhang, Hui Wang, Rui Dong, Xiaomeng Yang, Yi Liu, Yanhui Ma
BACKGROUND: High resolution melting (HRM) is a simple, flexible and low-cost mutation screening technique. The methylenetetrahydrofolate reductase (MTHFR) gene encoding a critical enzyme, potentially affects susceptibility to some congenital defects like congenital heart disease (CHD). We evaluate the performance of HRM for genotyping of the MTHFR gene C677T locus in CHD cases and healthy controls of Chinese Han population. METHODS: A total of 315 blood samples from 147 CHD patients (male72, female 75) and 168 healthy controls (male 92, female 76) were enrolled in the study...
2016: PloS One
https://www.readbyqxmd.com/read/26786543/nationwide-hospitalization-trends-in-adult-congenital-heart-disease-across-2003-2012
#13
Shikhar Agarwal, Karan Sud, Venu Menon
BACKGROUND: We aimed to assess trends in hospitalization, outcomes, and resource utilization among patients admitted with adult congenital heart disease (ACHD). METHODS AND RESULTS: We used the 2003-2012 US Nationwide Inpatient Sample for this study. All admissions with an ACHD were identified using standard ICD codes. Resource utilization was assessed using length of stay, invasive procedure utilization, and cost of hospitalization. There was a significant increase in the number of both simple (101%) as well as complex congenital heart disease (53%)-related admissions across 2003-2012...
January 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/26681782/use-of-a-checklist-and-clinical-decision-support-tool-reduces-laboratory-use-and-improves-cost
#14
Claudia A Algaze, Matthew Wood, Natalie M Pageler, Paul J Sharek, Christopher A Longhurst, Andrew Y Shin
OBJECTIVE: We hypothesized that a daily rounding checklist and a computerized order entry (CPOE) rule that limited the scheduling of complete blood cell counts and chemistry and coagulation panels to a 24-hour interval would reduce laboratory utilization and associated costs. METHODS: We performed a retrospective analysis of these initiatives in a pediatric cardiovascular ICU (CVICU) that included all patients with congenital or acquired heart disease admitted to the cardiovascular ICU from September 1, 2008, until April 1, 2011...
January 2016: Pediatrics
https://www.readbyqxmd.com/read/26566873/cost-utility-and-budget-impact-analysis-of-drug-treatments-in-pulmonary-arterial-hypertension-associated-with-congenital-heart-diseases-in-thailand
#15
Watsamon Thongsri, Thanaporn Bussabawalai, Pattara Leelahavarong, Suthep Wanitkun, Kritvikrom Durongpisitkul, Usa Chaikledkaew, Yot Teerawattananon
OBJECTIVE: This study aims to compare the lifetime costs and health outcomes of both first-line and sequential combination treatments with standard treatment for pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) (PAH-CHD) patients. METHODS: A cost-utility analysis was performed using a Markov model based on a societal perspective. One-way and probabilistic sensitivity analyses were performed to investigate the effect of parameter uncertainty...
August 2016: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/26455384/hospital-resource-utilization-for-common-noncardiac-diagnoses-in-adult-survivors-of-single-cardiac-ventricle
#16
Michael D Seckeler, Tabitha G Moe, Ian D Thomas, Omar Meziab, Jennifer Andrews, Elissa Heller, Scott E Klewer
Single ventricle congenital heart disease (SV CHD) has transformed from a nearly universally fatal condition to a chronic illness. As the number of adults living with SV CHD continues to increase, there needs to be an understanding of health care resource utilization (HCRU), particularly for noncardiac conditions, for this patient population. We performed a retrospective database review of the University HealthSystem Consortium Clinical Database/Resource Manager for adult patients with SV CHD hospitalized for noncardiac conditions from January 2011 to November 2014...
December 1, 2015: American Journal of Cardiology
https://www.readbyqxmd.com/read/26219731/exploring-value-in-congenital-heart-disease-an-evaluation-of-inpatient-admissions
#17
Andrew Y Shin, Zhongkai Hu, Bo Jin, Sangeeta Lal, David N Rosenthal, Bradley Efron, Paul J Sharek, Scott M Sutherland, Harvey J Cohen, Doff B McElhinney, Stephen J Roth, Xuefeng B Ling
OBJECTIVES: Understanding value provides an important context for improvement. However, most health care models fail to measure value. Our objective was to categorize inpatient encounters within an academic congenital heart program based on clinical outcome and the cost to achieve the outcome (value). We aimed to describe clinical and nonclinical features associated with value. DESIGN: We defined hospital encounters based on outcome per resource utilized. We performed principal component and cluster analysis to classify encounters based on mortality, length of stay, hospital cost and revenue into six classes...
November 2015: Congenital Heart Disease
https://www.readbyqxmd.com/read/26184611/overall-hospital-cost-estimates-in-children-with-congenital-heart-disease-analysis-of-the-2012-kid-s-inpatient-database
#18
David Faraoni, Viviane G Nasr, James A DiNardo
This study sought to determine overall hospital cost in children with congenital heart disease (CHD) and to compare cost associated with cardiac surgical procedures, cardiac catheterizations, non-cardiac surgical procedures, and medical admissions. The 2012 Healthcare Cost and Utilization Project Kid's Inpatient Database was used to evaluate hospital cost in neonates and children with CHD undergoing cardiac surgery, cardiac catheterization, non-cardiac surgical procedures, and medical treatments. Multivariable logistic regression was applied to determine independent predictors for increased hospital cost...
January 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/26172576/factors-associated-with-inpatient-hospitalizations-among-patients-aged-1-to-64-years-with-congenital-heart-defects-arkansas-2006-to-2011
#19
Regina M Simeone, Matthew E Oster, Charlotte A Hobbs, James M Robbins, R Thomas Collins, Margaret A Honein
BACKGROUND: Individuals with congenital heart defects (CHDs) have high hospital resource use. We sought to identify factors associated with hospital costs and multiple hospitalizations among individuals with CHDs. METHODS: Data from the 2006 to 2011 Healthcare Cost and Utilization Project Arkansas State Inpatient Databases were linked across encrypted patient identifiers to develop a cohort of Arkansas residents aged 1 to 64 years who were hospitalized at least once with a CHD during this time period...
July 2015: Birth Defects Research. Part A, Clinical and Molecular Teratology
https://www.readbyqxmd.com/read/26110039/cost-effectiveness-analysis-of-acute-kidney-injury-biomarkers-in-pediatric-cardiac-surgery
#20
COMPARATIVE STUDY
Stanislava Petrovic, Natasa Bogavac-Stanojevic, Dragana Lakic, Amira Peco-Antic, Irena Vulicevic, Ivana Ivanisevic, Jelena Kotur-Stevuljevic, Zorana Jelic-Ivanovic
INTRODUCTION: Acute kidney injury (AKI) is significant problem in children with congenital heart disease (CHD) who undergo cardiac surgery. The economic impact of a biomarker-based diagnostic strategy for AKI in pediatric populations undergoing CHD surgery is unknown. The aim of this study was to perform the cost effectiveness analysis of using serum cystatin C (sCysC), urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine liver fatty acid-binding protein (uL-FABP) for the diagnosis of AKI in children after cardiac surgery compared with current diagnostic method (monitoring of serum creatinine (sCr) level)...
2015: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
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