217 - Disparities In Pediatric Cardiovascular Hospitalizations: A Multi-Year Analysis of Cost and Length of Stay Across Race and County in New York State

Publication Number: 1206.217

Noel A. Tomy, New York Medical College, White Plains, NY, United States; Benjamin Shwartzman, New York medical College, White plains, NY, United States; Supriya S. Jain, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, United States

Background: Equity in hospital resource use and outcomes for pediatric cardiovascular admissions remains poorly characterized, despite the substantial burden these conditions place on children and healthcare systems.

Objective: To evaluate differences in hospital length of stay (LOS) and total costs among pediatric patients (ages 0–17) hospitalized for cardiovascular conditions in New York State from 2022 to 2024, stratified by race/ethnicity, insurance, and hospital county.

Design/Methods: This retrospective cross-sectional study analyzed 6,177 pediatric (0–17 years) cardiovascular hospitalizations from the New York State SPARCS database (2022–2024). Patients were identified using CCSR circulatory system diagnosis codes. Extracted variables included age, sex, race/ethnicity (7 categories), insurance type (Medicaid, private, self-pay/other), hospital county, length of stay (LOS), and total costs. Descriptive statistics were calculated for LOS and costs by race/ethnicity and county. Kruskal–Wallis tests assessed group differences, with Tukey-adjusted pairwise comparisons. Insurance distribution differences were evaluated using χ² testing.

Results: Among 6,177 pediatric cardiovascular hospitalizations (2022–2024), LOS and total costs differed significantly by race/ethnicity (p < 0.001). Multi-racial Hispanic patients had high costs ($124,848) and Other Race/Unknown had the longest LOS (11.2 days). Black/African American patients had longer LOS than White patients (mean difference 2.39 days, p=0.0069). Cost differences across groups were significant (p < 0.001), particularly for Other Race/Unknown, which had higher costs than White, Black/African American Hispanic, and Multi-racial Hispanic patients. County-level variation was significant (p < 0.001): New York County had the highest cost ($145,482), Monroe County the longest LOS (11.7 days), and Bronx County the lowest cost ($36,342) and shortest LOS (4.4 days). Medicaid coverage was associated with longer LOS and higher costs, including among Black/African American patients (9.2 vs 7.0 days; $84,702 vs $78,962).

Conclusion(s): Marked disparities in LOS and costs among hospitalized pediatric cardiovascular patients highlight structural inequities across race/ethnicity, geography, and insurance coverage. Addressing these gaps will require coordinated policy, reimbursement, and care delivery reforms that better support equitable access and resource allocation for pediatric cardiovascular populations.