Differences in Hospital Costs and Length of Stay Among Children with Down Syndrome

Infant with Down Syndrome

The journal Birth Defects Research Part A recently published a study that examined the differences in hospital costs and number of days spent in the hospital (length of stay) between children with Down syndrome who also had a congenital heart defect(CHD) or other major birth defect, and children with Down syndrome who did not have another major birth defect or CHD. This study provides useful information for evaluating patterns of hospital length of stay and costs for children with Down syndrome 0-8 years old. Read the abstract for the study hereexternal icon.

Main Findings from this Study

Comparing differences between hospital costs

  • Compared to children with isolated Down syndrome, which are children with Down syndrome who did not have a CHD or other major birth defect:
    • Children with Down syndrome and a severe CHD had approximately 11 times higher hospital costs during the first year of life.
    • Children with Down syndrome and a non-severe CHD had 2 times higher hospital costs during the first year of life.
    • Children with Down syndrome and a major birth defect other than a CHD had 4 times higher hospital costs during the first year of life.

Comparing differences between length of hospital stay

  • Compared to children with isolated Down syndrome:
    • Children with Down syndrome and a severe CHD spent more than 5 times as many days in the hospital during the first year of life.
    • Children with Down syndrome and a non-severe CHD spent twice as many days in the hospital during the first year of life.
    • Children with Down syndrome and a major birth defect other than CHD spent more than 3 times as many days in the hospital during the first year of life.

Overall

  • During early childhood, hospital costs were significantly higher for children with Down syndrome who also had a CHD (either severe or non-severe) than for children with isolated Down syndrome, but this difference in hospital costs became less pronounced as the children got older.

Estimated median hospital costs by age for children with Down syndrome born in Florida, 1998-2007

This graph is a depiction of the differences in hospital costs by age for children with Down syndrome both with and without other major birth defects, including severe congenital heart defects.  During early childhood, hospital costs were significantly higher for children with Down syndrome who also had a CHD (either severe or non-severe) than for children with isolated Down syndrome.  This difference in hospital costs became less pronounced as the children got older.

About this Study

  • Researchers used data from the Florida Birth Defects Registry, a statewide population-based system that collects information on babies born with birth defects in Florida. Population-based means that the researchers look at all babies with birth defects who live in a defined study area, in order to get a complete picture of what is happening among all of the people (the population) living in the study area. This study included babies born with Down syndrome from 1998-2007.
  • This study adds more information about infants and children with Down syndrome and hospital costs. It provided:
    • Comparison of hospital costs and number of days in the hospital for children with Down syndrome beyond the first few years of life.
    • Comparison of hospital costs and number of days in the hospital for children with Down syndrome who also had a severe or a non-severe CHD, or other major birth defect other than a CHD.

CDC’s Activities: Down Syndrome

  • Tracking: Tracking the occurrence of Down syndrome gives us important clues for opportunities to improve outcomes and helps plan for the needs of families.
  • Research: To understand how Down syndrome impacts affected children and their families, CDC and its partners conduct studies on health service use, survival, and racial/ethnic health disparities.

CDC and its partners continue to look at these issues to improve the lives of children and families affected by Down syndrome.

Reference for the Key Findings

Dawson AL, Cassell CH, Oster ME, Olney RS, Tanner JP, Kirby RS, Correia J, Grosse SD. Hospitalizations and Associated Costs in a Population-Based Study of Children with Down Syndrome Born in Florida. Birth Defects Research Part A. 2014 [epub ahead of print].