Dysphagia

, Volume 29, Issue 5, pp 545–552

The One-Year Attributable Cost of Post-stroke Dysphagia

  • Heather Shaw Bonilha
  • Annie N. Simpson
  • Charles Ellis
  • Patrick Mauldin
  • Bonnie Martin-Harris
  • Kit Simpson
Original Article

DOI: 10.1007/s00455-014-9543-8

Cite this article as:
Bonilha, H.S., Simpson, A.N., Ellis, C. et al. Dysphagia (2014) 29: 545. doi:10.1007/s00455-014-9543-8

Abstract

With the recent emphasis on evidence-based practice and healthcare reform, understanding the cost of dysphagia management has never been more important. It is helpful for clinicians to understand and objectively report the costs associated with dysphagia when they advocate for their services in this economy. Having carefully estimated cost of illness, inputs are needed for cost-effectiveness analyses that help support the value of treatments. This study sought to address this issue by examining the 1-year cost associated with a diagnosis of dysphagia post-stroke in South Carolina. Furthermore, this study investigated whether ethnicity and residence differences exist in the cost of dysphagia post-stroke. Data on 3,200 patients in the South Carolina Medicare database from 2004 who had ICD-9 codes for ischemic stroke, 434 and 436, were retrospectively included in this study. Differences between persons with and without dysphagia post-stroke were compared with respect to age, gender, ethnicity, mortality, length of stay, comorbidity, rurality, discharge disposition, and cost to Medicare. Univariate analyses and a gamma-distributed generalized linear multivariable model with a log link function were completed. We found that the 1-year cost to Medicare for persons with dysphagia post ischemic stroke was $4,510 higher than that for persons without dysphagia post ischemic stroke when controlling for age, comorbidities, ethnicity, and proportion of time alive. Univariate analysis revealed that rurality, ethnicity, and gender were not statistically significantly different in comparisons of individuals with or without dysphagia post-stroke. Post-stroke dysphagia significantly increases post-stroke medical expenses. Understanding the expenditures associated with post-stroke dysphagia is helpful for optimal allocation and use of resources. Such information is needed to conduct cost-effectiveness studies.

Keywords

Deglutition Deglutition disorders Dysphagia Cost Stroke Length of stay Discharge severity 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Heather Shaw Bonilha
    • 1
    • 2
    • 3
  • Annie N. Simpson
    • 3
    • 4
  • Charles Ellis
    • 1
  • Patrick Mauldin
    • 5
  • Bonnie Martin-Harris
    • 1
    • 2
    • 3
    • 6
  • Kit Simpson
    • 4
  1. 1.Department of Health Sciences and ResearchMedical University of South CarolinaCharlestonUSA
  2. 2.Evelyn Trammell Institute of Voice and SwallowingMedical University of South CarolinaCharlestonUSA
  3. 3.Department of Otolaryngology – Head and Neck SurgeryMedical University of South CarolinaCharlestonUSA
  4. 4.Department of Healthcare Leadership and ManagementMedical University of South CarolinaCharlestonUSA
  5. 5.Division of General Medicine and Geriatrics, Department of MedicineMedical University of South CarolinaCharlestonUSA
  6. 6.VA Center for Disease Prevention and Health Interventions for Diverse PopulationsRalph H. Johnson VA Medical CenterCharlestonUSA