CREATING A “VALUE INDEX”: A METHOD TO COMPARE REGIONAL PROGRAMS PERFORMING CONGENITAL HEART SURGERY

Resource allocation challenges persist among surgical programs in the U.S. As healthcare policy moves increasingly toward value-based approaches, models to assist in comparing and evaluating programs become increasingly important. We used the Texas Hospital Inpatient Discharge Database to develop such a model. We included all patients under one year old, with primary surgical procedural codes for Total Anomalous Pulmonary Venous Connection, Transposition of the Great Arteries, and Tetralogy of Fallot (a congenital heart defect where not enough blood is able to reach the lungs to get oxygen). We examined mortality, length of stay, and total hospital charges data from January 2005 to June 2010. We used scatter plots to place programs into value quartiles. Three of the 11 surgical programs we identified appeared within the quartile of high-survival with low-charges and were identified as having high value. We performed additional risk-adjustment modeling and treatment pattern evaluation, and such information will have great importance for regional care planning.