부산대학교 도서관

Introduction: Data on the longitudinal health experience after pediatric cardiac surgery are limited. We examined chronic medication use by cardiac disease severity amongst publicly insured children in New York State over the course of childhood.Methods: We identified Medicaid-enrolled youth <18 years with a history of cardiac surgery in the NYS CHS-COLOUR database, which links clinical registry data to 14 years of New York State Medicaid data (2006-2019). We report total expenditures and prevalence of outpatient chronic medication use, defined as >90 days of a filled prescription.Results: Of 4.5 million children enrolled in Medicaid, 5,459 underwent cardiac surgery. Chronic medication expenditures were $4.1K/person-year for those with critical single ventricle disease (SV), $2.4K/person-year for critical biventricular disease (BV), $2.4K/person-year for non-critical cardiac disease (non-critical), and $0.3K/person-year for enrollees without a history of cardiac surgery (non-cardiac). Prevalence of chronic medication use was 0.65 (SV), 0.38 (BV), 0.37 (non-critical), and 0.15 (non-cardiac) enrollees/person-year. Prevalence of chronic medication use was higher for enrollees with cardiac surgery compared to non-cardiac enrollees: 16 times higher for cardiac/renal medications, 1.9 times higher for respiratory/allergy, 7.4 times higher for gastrointestinal, and 0.8 times higher for central nervous system medications (primarily driven by antiepileptics in enrollees <1 year and by psychotropics in adolescents). For enrollees with a history of cardiac surgery, patterns of medication use differed by age, medication type and disease severity (higher for SV compared to similar patterns of use for BV and non-critical, Figure).Conclusion: Chronic medication use is common and costly even years after pediatric cardiac surgery. Understanding longitudinal medication burden helps clinicians and families plan for future healthcare needs.