Different levels of care for follow-up of adults with congenital heart disease: a cost analysis scrutinizing the impact on medical costs, hospitalizations, and emergency department visits

To scrutinize the economic impact of different care levels, such as shared care, in follow-up adult congenital heart disease (ACHD) patients. The BELgian COngenital Database combining Administrative and Clinical data (BELCODAC) was analyzed. Patients (N = 6579) were categorized into five levels based on their cardiac pattern between 2006 2010. Medical costs, hospitalizations, emergency department visits measured 2011 2015. In patients with moderate lesions, highly specialized (HSC; exclusive by ACHD specialists) predominantly (SC+) associated significantly lower medical costs resource use compared to general (SC?) (GCC). patient population mild HSC better outcomes than SC? GCC, but SC+ not. fewer hospitalizations (? 33%) less pharmaceutical 46.3%) SC+. lesions no (NCC) group had those GCC groups, post-hoc analysis revealed that they a profile under care. More are or follow-up. Shared strong involvement specialists might be management option consider. Characteristics without good medium-term prospects should further scrutinized.