BUDGET IMPACT OF POST-STROKE DYSPHAGIA- DATABASE ANALYSES OF HOSPITAL DISCHARGES IN FRANCE AND SWITZERLAND
Author(s)
Muehlemann N1, de Léotoing L2, Jouaneton B2, Fernandes J3, Arnold M4, Kägi G5
1Nestlé Health Science, Epalinges, Switzerland, 2HEVA, LYON, France, 3Oc-Santé, Montpellier, France, 4University Hospital Bern, Bern, Switzerland, 5Kantonsspital St. Gallen, St.Gallen, Switzerland
OBJECTIVES: Oropharyngeal dysphagia is prevalent in hospitalized post-stroke patients and is associated with increased mortality and comorbidities. The aim of our analysis was to evaluate the impact of dysphagia on Length of Hospital Stay (LOS) and costs. The hospital perspective was used to assess costs. METHODS: Hospital discharge databases comparing hospital stays for stroke associated with dysphagia vs stroke without dysphagia in France and Switzerland were analyzed. The French Medical Information System Program (PMSI) database analysis focused on 62’297 stays for stroke in public sector. Diagnosis codes and listing of procedures were used to identify dysphagia in stroke patients. RESULTS: Patients with post-stroke dysphagia accounted for 8.4% of stroke hospital stays in Switzerland, which is consistent with recently reported prevalence of dysphagia at hospital discharge (Arnold et al, 2016). The French database analysis identified 4.2% stays with post-stroke dysphagia. We hypothesize that the difference between the Swiss and French datasets may be explained by the limitations of the analysis based on diagnosis and procedure coding. Post-stroke dysphagic patients stayed longer at hospitals (LOS of 23.7 vs. 11.8 days in France and LOS of 14.9 vs. 8.9 days in Switzerland) as compared to post-stroke patients without dysphagia. Post-stroke dysphagia was associated with €3’000 and CHF14’000 cost increase in France and Switzerland respectively. CONCLUSIONS: Post-stroke dysphagia is associated with increase of length of hospital stay and higher hospital costs.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCV36
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders, Gastrointestinal Disorders