The Financial and Emotional Costs of Heart Screenings

As I write this, Mason Tellez, a track athlete from Whittier High School, remains hospitalized.  According to a statement by his mother, he collapsed during practice with an undetected heart condition.  “He remains in serious condition, but at this point is breathing on his own.”

mason tellezOur prayers and thoughts are with Mason and his family.

Sudden cardiac arrest is the #1 cause of death of student athletes.  It takes the lives of thousands of students every year.  Despite these numbers, checking our children’s hearts is not a standard of care.  As a society, we prefer the wait and see approach.  That strategy didn’t work out too well for my family, and I’m sure that the Tellez family would have preferred another option too.

One of the strongest objections to screening our kids’ hearts is the cost argument.  It’s just too expensive to screen our kids . . .. It is difficult to have a rationale conversation about healthcare costs because the system is so broken. It is hard to ascertain actual costs because there is very little consistency.  However, as Mason is hopefully recovering, I think we should try.

According to Fallon Health (the first link in my Google search that revealed costs), an average doctor office EKG exam costs $43. There are 7.7 million high school student athletes in this country.  If each student athlete got an EKG exam, it would cost $331,100,000.

According to a report filed by CNN, the average bill for treatment of a heart attack without major complications at a hospital is $47,695. This is not a perfect comparison, because a heart attack is not sudden cardiac arrest and a child is not an adult. However, the purposes of this discussion, this figure is good enough.

According to Becker’s Hospital Review, the average cost of a day in a for-profit hospital is around $1,800, and the average hospital stay of an adult following cardiac arrest is 3.8 days.

Combining all of the information above, it costs $47,695 to treat the heart attack and $6,840 for the hospital stay, for a total cost of $54,535.

If we divide the cost of screening all of our student athletes ($331,100,000) by the average cost of treating an adult for a heart attack ($54,535), we get 6,071. To put another way, we could screen 8,000,000 students for the same cost of treating 6,071 students who were hospitalized from sudden cardiac arrest.

Are there 6,000 students that suffer from cardiac arrest and survive?  Probably, but we don’t have a good understanding of that number because we’ve never tracked it. Last October, the CDC and NIH finally established a sudden cardiac arrest registry for youth.

But let’s look at this another way.  Youth heart screenings, in addition to discover heart conditions that lead to sudden cardiac arrest and death in our children, also reveal risk factors of hyptertension and obesity – the precursors to heart disease. Heart disease is the #1 cause of death of adults in this country – about 400,000 per year.  By preventing heart disease among students, is there additional cost savings?

It’s hard to imagine that a society who has the tools to detect and prevent heart disease and sudden death among children doesn’t use them. It’s hard to believe that $1 out of every $6 spent on health care is for cardiovascular disease, or $444 billion per year. The cost to screen all of the hearts of the high school student athletes .007% of that big billion dollar number.

So, if you’re one of those numbers or economic folks who likes to assess the return on investment, what’s a better strategy? Oh, and before you answer, pretend that Mason is your child. Consider the financial toll on the system and the emotional toll on his family. It all probably could have been avoided with a heart screening.