Effect of prenatal diagnosis on hospital costs in complete transposition of the great arteries

What's already known about this topic? Congenital heart disease continues to be a resource‐intense field. Prenatal diagnosis of congenital heart disease is associated with improved clinical outcomes Its financial implications are not well known. What does this study add? We performed the first ever direct inpatient hospital cost comparison in infants with and without a prenatal diagnosis of complete transposition of the great arteries. Transportation costs contributed significantly to the difference in total hospital cost. Objective Prenatal diagnosis of congenital heart disease (CHD) is associated with improved clinical outcomes, yet its impact on the cost of hospitalization is not well described. We hypothesized that prenatal diagnosis of complete transposition of the great arteries (d‐TGA) results in lower total hospital costs compared with postnatal diagnosis. Methods Retrospective analysis of infants with d‐TGA repaired at our center from July 2006 to 2014. Total charges from initial hospitalization until discharge were converted to costs using the cost‐to‐charge ratio and then converted into 2016 dollars using the consumer price index. A direct cost comparison from the hospital perspective was performed between groups. A secondary analysis included the cost of prenatal diagnosis. Results Thirty‐three infants with d‐TGA were identified; 8 with and 25 without prenatal diagnosis. There was no difference in baseline characteristics. Mean direct cost of hospitalization was higher in infants without prenatal diagnosis ($108 014 ± $51 305 vs $88 305 ± $22 896, P = .31). On secondary analysis, the cost of prenatal diagnosis was negligible compared with total hospital cost. Conclusions Total cost of initial hospitalization was higher for infants without prenatal diagnosis of d‐TGA. Prenatal diagnosis not only improves clinical outcomes but may also be cost saving in the current era of increasing health care costs.