Hospital costs ‘hard to swallow’

Dysphagia, or swallowing impairment, is a little recognised medical problem inflicting a significant cost on our health system.

Researchers from Flinders University have found that people in hospital who also have dysphagia need to stay in hospital for longer periods, adding up to US$12,000 (AU$16,000) per visit.

Lead researcher Dr Stacie Attrill and Dr Sebastian Doeltgen, Head of the Swallowing Neurorehabilitation Research Lab at the Centre for Neuroscience at Flinders University, say the research team’s systematic review and meta-analysis of 23 cohort studies from Europe and North America found that people with dysphagia stay, on average, for three days longer in hospital – regardless of their diagnosis – and this costs the health care system an average of 40% more than people without impaired swallowing.

The research team, from left to right: Dr Joanne Murray, Dr Sarahlouise White, Dr Sebastian Doeltgen, Dr Stacie Attrill and Mrs Sue Hammond

More than 100,000 Australians are living with the effects of dysphagia at any time as a common consequence of many well-known health conditions such as stroke, Motor Neurone Disease, Parkinson’s Disease, and head and neck cancer.

Dysphagia has many negative impacts on health, and can lead to choking, lung infection, malnutrition and dehydration.

However, the extent and influence of this detrimental symptom are not widely recognised, or acted on.

Dr Doeltgen, whose research focus is on using neuromodulation to improve swallowing function, says findings from the new study are an important wake-up call for health care systems around the world and action needs to be taken to address and reduce dysphagia-related health issues.

“This is an important opportunity to raise awareness about swallowing disorders in general, as they are a very common and costly consequence of many well-known health conditions … yet we hardly ever hear about them,” says Dr Doeltgen, from speech pathology at the College of Nursing and Health Sciences.

Dr Attrill says the research “highlights the need to recognise how dysphagia contributes to pressure on our healthcare systems”.

“Hospital procedures that facilitate early identification, and timely and evidence-based management of dysphagia across any clinical population, are likely to reduce negative health outcomes and healthcare costs that result from dysphagia,” Dr Attrill says.

Co-author Dr Joanne Murray adds: “We see this frequently in our hospitals: Patients with dysphagia tend to stay longer and recover slower than patients with the same diagnosis, but without dysphagia.”

The research findings – ‘Impact of oropharyngeal dysphagia on healthcare cost and length of stay in hospital: a systematic review‘, by S Attrill, S White, J Murray, S Hammond and S Doeltgen – is now online on the BMC Health Services Research website.

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