My hospital administrator wants to reduce costs and thinks that reducing dysphagia services will save money. What data is there to show that dysphagia services are cost-effective?
The Agency for Health Care Policy and Research (AHCPR) developed a report about dysphagia in 1999. They found that bedside exams can detect aspiration risk with an 80% accuracy rate. Using this figure, and the fact that approximately 75% of all stroke patients exhibit some form of dysphagia, it was concluded that 150 of every 1000 stroke patients who aspirate would be missed. The AHCPR report noted that 37% of patients with aspiration develop aspiration pneumonia. Therefore, approximately 56 of the 150 patients missed would develop pneumonia at a cost of $11, 000-$15, 000 per hospital course of treatment for pneumonia (total cost = $616,000-$840,000). More recent data indicates that the average cost of hospitalization for people who have pneumonia post-stroke is $21,043, compared to $6,206 for people who have had a stroke without pneumonia. This is a $14,836 increase per patient and the researchers found that in their sample of Medicare patients, pneumonia occurred in 5.6% of those who
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