Dysphagia has been previously shown to increase hospital length of stay (LOS) (Altman et al, 2010). The objective of this study was to quantify the difference in hospital charges between patients identified with and without dysphagia among commonly associated neuromuscular, neurologic and cardiovascular diseases.

Using 2008 Health Care Utilization Project (HCUP) data, individuals with a hospital discharge diagnosis of stroke, Alzheimer’s disease (AD), ALS, dementia, heart failure (HF), multiple sclerosis, cerebral palsy, Huntington’s disease, and Parkinson’s disease (PD) were identified using ICD-9 CM diagnosis codes. Within each disease state, the mean (10% trimmed) hospital charges for individuals with a recorded diagnosis of dysphagia (ICD-9: 438.82, 787.2-787.29) were compared to those without dysphagia. An analysis of covariance (ANCOVA) model was employed to account for potential impact of comorbidities on hospital charges. The model was adjusted for dysphagia diagnosis as a factor and both 1) number of comorbidities, and 2) dysphagia diagnosis and number of comorbidities interaction as covariates.

Dyphasgia was most commonly diagnosed in patients with stroke (41.2%, n=11,736), dementia (0.6%, n=1,126), AD (0.4%, n=489) and HF (0.3%, n=2,087). Cerebral palsy, PD, HD, and ALS were excluded from the analysis due to small dysphagia sample (n<10). Patients with dysphagia demonstrated higher mean hospital charges compared with non-dysphagia patients for stroke ($32,531 vs. $26,004, p<0.001), dementia ($26,836 vs. $23,445, p<0.001), AD ($25,431 vs. $22,915, p<0.001), HF ($30,686 vs. $26,984, p<0.001), and MS ($32,406 vs. $23,726, p<0.001) adjusted for number of comorbidities. The magnitude and direction of the association between dysphagia and hospital charges were consistent in both the bivariate and multivariate analyses.

Our results demonstrate that patients with conditions that are complicated by dysphagia cost hospitals significantly more than similar patients without dysphagia and management of these patients can avert significant costs.