Cardiac care for infants: determinants of hospital charges for acute care

Article Abstract:

As progress in the diagnosis and treatment of congenital heart disease has occurred over the last 20 years, an increasing number of reparative operations have been performed early in the first year of life. This has led to a reduction in later surgeries and hospitalizations. As more attention has become focused on issues such as cost of and access to medical care, it is important to analyze costs and benefits associated with treatment of heart disease in infants. Using the medical records of 93 infants who were treated for heart disease from August 1987 through June 1989 at the John Hopkins Hospital Children's Center, diagnoses, treatments and costs were assessed. Of the 93 infants, 33.3 percent had complex heart disease, 31.2 percent had extracardiac defects (of organs other than the heart), and 10.8 percent had both types of problems. Twenty-four infants died before the age of one year. Surgery was performed on 66 patients. Infants were hospitalized from 1 to 241 days, and 23 infants needed hospital care for more than 28 days in their first year. Hospital charges were broken down into specific areas, including routine care, blood products, pharmacy, operating room, therapy, laboratory and so forth. Of the total hospital cost of $3,417,612, 93 percent was reimbursed. Costs for infants with extracardiac defects were significantly higher. The hospital costs of infants with less complex heart disease and no other defects were 61 percent lower than those of infants with more complex disease. The presence of complex disease, use of surgical treatment, and length of stay in intensive care significantly and independently influenced hospital charges. The ratio of lifetime earnings (estimated conservatively) to cost of early treatment was 5.4 to 1. The findings suggest that early repair of heart defects is both therapeutically and economically beneficial. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects

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Tales of the riverbank

Article Abstract:

Heart surgeon Magdi Yacoub frequently returns to his native Egypt to undertake life-saving operations on children with congenital heart disease. His work is carried out through the charity Chain of Hope. His visits to Egypt always attract large crowds, particularly parents desperate to get help for their children. When he operated recently at Abou Eresh and Kasr El Aini hospitals in Cairo, Egypt, people travelled from across the country hoping to be seen. Those who work with him find this work exhausting but rewarding.

Behavior, Surgery, Heart, Surgeons, Heart surgery, Yacoub, Magdi

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Tales of the expected

Article Abstract:

Stories and myths are an important part of the culture which is central to determining and reflecting the nature of the NHS. Organizational stories are recounted to given an insight into how an organization works, while myths are more fanciful. The urban myth also contributes to the culture of the NHS and they can be funny, macabre or absurd, but they have universality. The harmful influence that myths can exert has been highlighted, and it is the response to myths that determines what action will follow.

Analysis, Beliefs, opinions and attitudes, Mythology, Socialized medicine

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