25124730

PMC4617639

Background

Our objective was to examine differences in hospital resource utilization for children with Down syndrome by age and the presence of other birth defects, particularly severe and non-severe congenital heart defects (CHDs).

Methods

This was a retrospective, population-based, statewide study of children with Down syndrome born 1998-2007, identified by the Florida Birth Defects Registry (FBDR) and linked to hospital discharge records for 1-10 years after birth. To evaluate hospital resource utilization, descriptive statistics on number of hospitalized days and hospital costs were calculated. Results were stratified by isolated Down syndrome (no other coded major birth defect); presence of severe and non-severe CHDs; and presence of major FBDR-eligible birth defects without CHDs.

Results

For 2,552 children with Down syndrome, there were 6,856 inpatient admissions, of which 68.9% occurred during the first year of life (infancy). Of the 2,552 children, 31.7% (n=808) had isolated Down syndrome, 24.0% (n=612) had severe CHDs, 36.3% (n=927) had non-severe CHDs, and 8.0% (n=205) had a major FBDR-eligible birth defect in the absence of CHD. Infants in all three non-isolated DS groups had significantly higher hospital costs compared to those with isolated Down syndrome. From infancy through age 4, children with severe CHDs had the highest inpatient costs compared to children in the other sub-groups.

Conclusions

Results support findings that for children with Down syndrome the presence of other anomalies influences hospital use and costs, and children with severe CHDs have greater hospital resource utilization than children with other CHDs or major birth defects without CHDs.

CDC Public Access

CC999999/Intramural CDC HHS/United States