Healthcare utilization trends for adolescents and young adults with moderate and severe congenital heart disease.

BACKGROUND

Improved congenital heart disease (CHD) care allows >90% of patients to live into adulthood. Young adult CHD patients experience challenges managing their cardiac conditions and other comorbidities that may increase healthcare utilization. There are limited data on hospitalizations of adolescents and young adults with CHD, specifically during the transition from pediatric to adult care. We hypothesized increased healthcare utilization for CHD patients transitioning from adolescent to adult care.

MATERIALS AND

METHODS

Retrospective review of the Vizient® Clinical Data Base (national, administrative database) for admissions from October 2019 to December 2023, aged 10-29 years with International Classification of Diseases-10 codes for moderate or severe CHD, stratified into age categories. Data included demographics, hospital outcomes, insurance status, admission through the emergency department (ED), and costs. Comparisons were made between the age groups.

RESULTS

There were 16,284 admissions during the study period. As age increased, the proportion of female admissions rose, with a higher prevalence of white admissions and a lower prevalence of Hispanic admissions. There was a decline in public insurance coverage, while rates of uninsured status and ED admissions increased with age. Mortality rates were highest at 15-19 years and 25-29 years.

CONCLUSIONS

Despite increased admissions from the ED, complications, and mortality, healthcare costs declined between the younger and older age groups. There were higher rates of uninsured status and ED admissions for hospitalized young adults with CHD transitioning from pediatric to adult care. However, overall hospital costs decreased. More studies are needed to guide improvements in care during this at-risk time.