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Characteristics of Adults With Congenital Heart Defects in the United States
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2020-07-01 , DOI: 10.1016/j.jacc.2020.05.025
Michelle Gurvitz 1 , Julie E Dunn 2 , Ami Bhatt 3 , Wendy M Book 4 , Jill Glidewell 5 , Carol Hogue 4 , Angela E Lin 6 , George Lui 7 , Claire McGarry 8 , Cheryl Raskind-Hood 4 , Alissa Van Zutphen 9 , Ali Zaidi 10 , Kathy Jenkins 1 , Tiffany Riehle-Colarusso 5
Affiliation  

BACKGROUND In the United States, >1 million adults are living with congenital heart defects (CHDs), but gaps exist in understanding the health care needs of this growing population. OBJECTIVES This study assessed the demographics, comorbidities, and health care use of adults ages 20 to 64 years with CHDs. METHODS Adults with International Classification of Disease-9th Revision-Clinical Modification CHD-coded health care encounters between January 1, 2008 (January 1, 2009 for Massachusetts) and December 31, 2010 were identified from multiple data sources at 3 U.S. sites: Emory University (EU) in Atlanta, Georgia (5 counties), Massachusetts Department of Public Health (statewide), and New York State Department of Health (11 counties). Demographics, insurance type, comorbidities, and encounter data were collected. CHDs were categorized as severe or not severe, excluding cases with isolated atrial septal defect and/or patent foramen ovale. RESULTS CHD severity and comorbidities varied across sites, with up to 20% of adults having severe CHD and >50% having ≥1 additional cardiovascular comorbidity. Most adults had ≥1 outpatient encounters (80% EU, 90% Massachusetts, and 53% New York). Insurance type differed across sites, with Massachusetts having a large proportion of Medicaid (75%) and EU and New York having large proportions of private insurance (44% EU, 67% New York). Estimated proportions of adults with CHD-coded health care encounters varied greatly by location, with 1.2 (EU), 10 (Massachusetts), and 0.6 (New York) per 1,000 adults based on 2010 census data. CONCLUSIONS This was the first surveillance effort of adults with CHD-coded inpatient and outpatient health care encounters in 3 U.S. geographic locations using both administrative and clinical data sources. This information will provide a clearer understanding of health care use in this growing population.

中文翻译:

美国先天性心脏病成人的特征

背景 在美国,超过 100 万成年人患有先天性心脏缺陷 (CHD),但在了解这一不断增长的人口的医疗保健需求方面存在差距。目的 本研究评估了 20 至 64 岁患有冠心病的成年人的人口统计、合并症和医疗保健使用情况。方法 2008 年 1 月 1 日(马萨诸塞州为 2009 年 1 月 1 日)至 2010 年 12 月 31 日期间,国际疾病分类第 9 次修订-临床修改 CHD 编码的医疗保健遭遇的成年人从美国 3 个站点的多个数据源中确定:埃默里大学(欧盟)在佐治亚州亚特兰大(5 个县)、马萨诸塞州公共卫生部(全州)和纽约州卫生部(11 个县)。收集了人口统计、保险类型、合并症和遭遇数据。CHD 分为严重或不严重,不包括孤立的房间隔缺损和/或卵圆孔未闭的病例。结果 CHD 的严重程度和合并症因地点而异,高达 20% 的成人患有严重的 CHD,>50% 的成人患有 ≥1 种额外的心血管合并症。大多数成年人有 ≥1 次门诊就诊(80% 欧盟、90% 马萨诸塞州和 53% 纽约)。不同地点的保险类型不同,马萨诸塞州拥有很大比例的医疗补助(75%),欧盟和纽约拥有很大比例的私人保险(欧盟 44%,纽约 67%)。根据 2010 年人口普查数据,每 1,000 名成年人中有 1.2 人(欧盟)、10 人(马萨诸塞州)和 0.6 人(纽约),估计患有冠心病编码医疗保健的成年人比例因地点而异。结论 这是在美国 3 个地理位置使用行政和临床数据源对患有 CHD 编码住院和门诊医疗保健的成年人进行的首次监测工作。这些信息将使人们更清楚地了解这一不断增长的人口中的医疗保健使用情况。
更新日期:2020-07-01
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