Jeon Bea B, Peiffer Sarah, Larabee Shannon M, Hosek Kathleen, Alonso Dailen, Lee Timothy C, Keswani Sundeep G, King Alice
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States.
Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, United States.
Front Surg. 2025 Jul 16;12:1620628. doi: 10.3389/fsurg.2025.1620628. eCollection 2025.
Congenital anomalies (CAs) impact 3% of live births and account for disproportionately high healthcare costs. While many CAs require multidisciplinary care and surgical intervention, the overall financial impact of infants diagnosed with CA with surgical needs is unknown. We aim to evaluate and characterize the charges of care in infants with CA and surgical needs in Texas.
A database study using the Texas Inpatient Public Use Data File was performed to query infants (<365 days) statewide from 1/2021 to 12/2021 for admissions with CA and involved organ system by ICD-10 codes. Encounters transferred to an outside hospital were excluded to avoid systematic double-counting. Descriptive statistics were performed.
Of 376,215 total admissions, 81,666 had surgical needs with OR charges. While non-CA represent the majority of surgical admissions (63,895/81,666; 78.24%), CA-surgical admissions represent 73.3% ($4.766/$6.496 billion) surgical admissions charges. Of CA-surgical admissions, 78.9% were single organ-system (1CA) with 14.5% with two organ-systems (2CA), 4.0% with three organ-system (3CA) and 2.6% with 4 + organ-systems (4 + CA). The proportion of admissions with surgical needs increases with the number of CA organ-systems involved. The median charge per CA-surgical admission was $1,296 for1CA, $4,517 for 2CA, $20,272 for 3 CA, and $25,313 for 4 + CA compared to the $797 for non-CA surgical admissions. Surgical admission charges increase with the number of CA organ-systems involved.
Surgical care of CA in infants is associated with significant healthcare utilization, accounting for $4.8 billion (73.4%) of all inpatient charges in 2021 despite representing a minority of admissions. Increasing number of CA organ-systems involved is associated with an increased proportion of patients with surgical admissions and increased median charge of admission.
先天性异常（CAs）影响3%的活产婴儿，且医疗费用高得不成比例。虽然许多先天性异常需要多学科护理和手术干预，但对于诊断为有手术需求的先天性异常婴儿的总体经济影响尚不清楚。我们旨在评估并描述德克萨斯州有手术需求的先天性异常婴儿的护理费用。
利用德克萨斯州住院患者公共使用数据文件进行数据库研究，以查询2021年1月至2021年12月全州范围内年龄小于365天、因先天性异常入院且按国际疾病分类第十版（ICD - 10）编码涉及器官系统的婴儿。转至外部医院的病例被排除，以避免系统性重复计数。进行描述性统计。
在376,215例总入院病例中，81,666例有手术需求并产生手术室费用。虽然非先天性异常占手术入院病例的大多数（63,895/81,666；78.24%），但先天性异常 - 手术入院病例占手术入院费用的73.3%（47.66亿美元/64.96亿美元）。在先天性异常 - 手术入院病例中，78.9%为单器官系统（1CA），14.5%为两个器官系统（2CA），4.0%为三个器官系统（3CA），2.6%为4个及以上器官系统（4 + CA）。有手术需求的入院病例比例随着涉及的先天性异常器官系统数量增加而上升。与非先天性异常手术入院病例的797美元相比，先天性异常 - 手术入院病例的中位数费用分别为：1CA为1,296美元，2CA为4,517美元，3CA为20,272美元，4 + CA为25,313美元。手术入院费用随着涉及的先天性异常器官系统数量增加而增加。
婴儿先天性异常的手术护理与大量医疗资源利用相关，尽管在入院病例中占少数，但在2021年占所有住院费用的48亿美元（73.4%）。涉及的先天性异常器官系统数量增加与手术入院患者比例增加以及入院中位数费用增加相关。
