142nd APHA Annual Meeting and Exposition

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Factors associated with high hospital resource utilization in a population-based study of children with orofacial clefts

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Hilda Razzaghi, PhD , Centers for Disease Control and Prevention, atlanta, GA
Russell Kirby, PhD , Maternal and Child Health, University of South Florida, Tampa, FL
April Dawson, MPH , Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Scott Grosse, PhD , Centers for Disease Control and Prevention, Atlanta, GA
Richard Olney, MD , Centers for Disease Control and Prevention, Atlanta, GA
Jane Correia , Florida Department of Health, Tallahassee, FL
Cynthia Cassell, PhD , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, DHHS, Atlanta, GA
We aimed to identify selected maternal/household and child characteristics associated with high hospital resource utilization for children with orofacial clefts (OFC), one of the most common categories of birth defects in the United States.

This was a statewide, population-based, retrospective, observational study of children with OFC born 1998-2007 identified by the Florida Birth Defects Registry and linked with hospital discharge records. We stratified results by infant’s age, cleft type [cleft lip with cleft palate (CLP), cleft palate only (CPO), and cleft lip only (CLO)], and by isolated vs. multiple (presence of other coded major birth defects) OFC. We used Poisson regression to analyze associations between selected characteristics and high hospital resource utilization (defined as 90th percentile of estimated hospitalized days and inpatient costs) for birth and post-birth hospitalizations and all hospitalizations initiated before age two years.

We included 2,585 children with OFC. Infants with low or very low birth weight (<2500 and <1500 grams, respectively) were significantly more likely to have high birth hospitalization costs for CLP [adjusted prevalence ratio (aPR): 2.01 (95% confidence interval (CI): 1.43-2.82)], CPO [aPR: 1.58 (95% CI: 1.16-2.14)], and CLO [aPR: 4.80 (95% CI: 2.19-10.53)]. Presence of multiple birth defects was associated with a 2-8 fold adjusted prevalence of high birth hospitalization costs and days and a modest but statistically greater prevalence of high hospitalization costs and days post-birth and overall for children with CLP, CPO, and CLO.

Multiple birth defects and low birth weight contribute to high hospitalization costs and days for children with OFC.

Learning Areas:

Epidemiology

Learning Objectives:
Identify selected maternal/household and child characteristics associated with high hospital resource utilization for children with orofacial clefts

Keyword(s): Health Care Costs, Birth Defects

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author and presenter because I am an expert on cleft costs and have worked in this field for 10+ years. I was also the PI of the funded grant, which led to this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 2041.0: Poster Session: Policy & Finance and Health Services Research