Article

Direct health care costs of laryngeal diseases and disorders

Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA.
The Laryngoscope (Impact Factor: 2.03). 07/2012; 122(7):1582-8. DOI: 10.1002/lary.23189
Source: PubMed

ABSTRACT To estimate the annual direct costs associated with the diagnosis and management of laryngeal disorders.
Retrospective analysis of data from a large, nationally representative, administrative US claims database.
Patients with a laryngeal disorder based on International Classification of Diseases,Ninth Revision-Clinical Modification codes from January 1, 2004 to December 31, 2008 and who were continuously enrolled for 12 months were included. Data regarding age, gender, geographic location, and type of physician providing the diagnosis were collected. Medical encounter, medication, and procedure costs were determined. Total and mean costs per person for 12 months were determined.
Of almost 55 million individuals in the database, 309,300 patients with 12 months follow-up, mean age of 47.3 years (standard deviation: 21.3), and 63.5% female were identified. Acute and chronic laryngitis, nonspecific causes of dysphonia, and benign vocal fold lesions were the most common etiologies. The total annual direct costs ranged between $178,524,552 to $294,827,671, with mean costs per person between $577.18 and $953.21. Pharmacy claims accounted for 20.1% to 33.3%, procedure claims 50.4% to 69.9%, and medical encounter claims 16.3% to 8.6% of overall direct costs. Antireflux medication accounted for roughly 10% and antibiotics 6% of annual direct costs.
This study establishes the economic impact of the assessment and management of patients with laryngeal disorders and permits cost comparisons with other diseases.

0 Followers
 · 
73 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Laryngeal endoscopy with stroboscopy (LES) remains the clinical gold standard for assessing vocal fold function. LES is used to evaluate the efficacy of voice treatments in research studies and clinical practice. LES as a voice treatment outcome tool is only as good as the clinician interpreting the recordings. Research using LES as a treatment outcome measure should be evaluated based on rater methodology and reliability. The purpose of this literature review was to evaluate the rater-related methodology from studies that use stroboscopic findings as voice treatment outcome measures.
    Journal of voice: official journal of the Voice Foundation 09/2014; 29(1). DOI:10.1016/j.jvoice.2014.06.014 · 0.94 Impact Factor
  • Otolaryngology Head and Neck Surgery 06/2013; 148(6 Suppl):S1-S37. DOI:10.1177/0194599813487301 · 1.72 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the accepted role of laryngoscopy in assessing patients with laryngeal/voice disorders, controversy surrounds its timing. This study sought to determine how increased time from first primary care to first otolaryngology outpatient visit affected the health care costs of patients with laryngeal/voice disorders.Methods Retrospective analysis of a large, national administrative claims database was performed. Patients had an ICD-9 coded diagnosis of a laryngeal/voice disorder, initially saw a primary care physician and subsequently an otolaryngologist as outpatients, and 6 months of follow-up data after the first otolaryngology evaluation. The outpatient health care costs accrued from the first primary care outpatient visit through the 6 months after the first otolaryngology outpatient visit were determined.Results260,095 unique patients saw a primary care physician as an outpatient for a laryngeal/voice disorder with 8999 (3.5%) subsequently seeing an otolaryngologist and with 6 months post-otolaryngology follow-up data. A generalized linear regression model revealed that compared to patients who saw an otolaryngologist ≤ 1 month after the first primary care visit, patients in the > 1 month and ≤ 3 months and > 3 months time period had a relative mean cost increase of $271.34 (95% confidence interval $115.95 to $426.73), and $711.38 (95% confidence interval $428.43 to $993.34), respectively.Conclusions Increased time from first primary care to first otolaryngology evaluation is associated with increased outpatient health care costs. Earlier otolaryngology examination may reduce health care expenditures in the evaluation and management of patients with laryngeal/voice disorders.
    The American Journal of Medicine 11/2014; DOI:10.1016/j.amjmed.2014.10.040 · 5.30 Impact Factor

Full-text

Download
4 Downloads
Available from
Mar 10, 2015