Trends in Hospital Charges for Heart Transplants in the United States

Purpose With the rising cost of health care it is important to understand the fiscal impact of resource-intensive treatments such as heart transplants. We hypothesized that hospital charges for heart transplants in the U.S. increased between 2004 and 2009 and investigated factors that may impact these hospital charges. Methods and Materials The Nationwide Inpatient Sample (NIS) database from the Healthcare Cost and Utilization Project was queried for all patients between 0 and 69 years of age who had heart transplants from 2004 to 2009. The database is a 20% stratified sample of all U.S. hospitals and 100% of all discharges from these hospitals. Factors that may affect these charges were analyzed. Results 1837 patient discharges were identified that reported hospital charges after heart transplants. The overall mean hospital charge for heart transplants between 2004 and 2009 was $424,711. This mean charge increased 66% from $320,997 in 2004 to $534,793 in 2009, with a greater increase among females (76.4%) compared to males (64.1%). Females had 4.2% higher charges compared to males, with the majority of this difference being among those under 40 years of age (8.7%) compared to those 40 years or older (1.0%). Trends in mean charges decreased with age from 0-9 year-olds to 40-49 year-olds, but increased again with age to 60-69 years-olds. [figure 1] Conclusions Mean hospital charges for heart transplants increased from 2004 to 2009, with charges being greatest for females, especially those under 40 years of age, and also for those at the extremes of age. There are many factors that contribute the hospital charges for heart transplants. Further studies are required to better determine what these factors are and how this knowledge can impact health care cost management.