Abstract 15800: Impact of an Early Extubation Clinical Practice Guideline on Hospital Costs in Infants Undergoing Cardiac Surgery: Results From the Pediatric Heart Network Collaborative Learning Study

Introduction: The Pediatric Heart Network (PHN) Collaborative Learning Study successfully increased early extubation rates after Tetralogy of Fallot (TOF) and coarctation (CoA) repair across participating sites by implementing a clinical practice guideline (CPG). The impact of the CPG on hospital costs remains unclear. Methods: PHN study data were linked to cost data from Children’s Hospital Association through matching on indirect identifiers. Costs were evaluated across active and control sites in the year before and after CPG implementation (with a 3-month washout period) using generalized linear mixed effects models accounting for within center clustering, the skewed distribution of costs, and important patient characteristics. A difference-in-difference approach was used to assess whether any changes observed in active sites were above and beyond secular trends in control sites. Results: Data were successfully linked on 471/510 (94.3%) eligible patients from 4 active and 4 control sites (1 model site...