ORIGINAL RESEARCH article
Front. Surg.
Sec. Pediatric Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1620628
This article is part of the Research TopicAdvances and Challenges in Neonatal Surgery: Congenital and Acquired ConditionsView all 19 articles
Increasing Surgical Healthcare Utilization for Infants with Congenital Anomalies in Texas
Provisionally accepted
Bea B Jeon1,2
Sarah Peiffer1,2Shannon M Larabee2Kathleen Hosek2
Dailen Alonso1,2Timothy C Lee1,2Sundeep G Keswani1,2
Alice King1,2*- 1Baylor College of Medicine, Houston, United States
- 2Texas Children's Hospital, Houston, Texas, United States
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Introduction: Congenital anomalies (CAs) impact 3% of live births and account for disproportionately high healthcare costs. While many CAs require multidisciplinary care and surgical intervention, the overall financial impact of infants diagnosed with CA with surgical needs is unknown. We aim to evaluate and characterize the charges of care in infants with CA and surgical needs in Texas. Methods: A database study using the Texas Inpatient Public Use Data File was performed to query infants (<365 days) statewide from 1/2021-12/2021 for admissions with CA and involved organ system by ICD-10 codes. Encounters transferred to an outside hospital were excluded to avoid systematic double counting. Descriptive statistics were performed. Results: Of 376,215 total admissions, 81,666 had surgical needs with OR charges. While non-CA represent the majority of surgical admissions (63,895/81,666; 78.24%), CA-surgical admissions represent 73.3% ($4.766/$6.496 billion) surgical admissions charges. Of CA-surgical admissions, 78.9% were single organ-system(1CA) with 14.5% with two organ-systems(2CA), 4.0% with three organ-system(3CA) and 2.6% with 4+ organ-systems(4+CA). The proportion of admissions with surgical needs increases with the number of CA organ-systems involved. The median charge per CA-surgical admission was $1,296 for1CA, $4,517 for 2CA, $20,272 for 3 CA, and $25,313 for 4+CA compared to the $797 for non-CA surgical admissions. Surgical admission charges increase with the number of CA organ-systems involved. Conclusions: Surgical care of CA in infants is associated with significant healthcare utilization, accounting for $4.8 billion (73.4%) of all inpatient charges in 2021 despite representing a minority of admissions. Increasing number of CA organ-systems involved is associated with an increased proportion of patients with surgical admissions and increased median charge of admission.
Keywords: Congenital anomalies (CAs), Burden of care, Cost of care, Charges of Care, Infant Surgical Care, Length of stay (LOS), Children's Surgery Verification (CSV), Disability-adjusted life years (DALY)
Received: 29 Apr 2025; Accepted: 02 Jul 2025.
Copyright: © 2025 Jeon, Peiffer, Larabee, Hosek, Alonso, Lee, Keswani and King. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Alice King, Baylor College of Medicine, Houston, United States
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