caa a22 4500 555285316 20200410031630.0 cr unu---uuuuu 190206e20190110xx s 000 0 eng 1932-6203 10.1371/journal.pone.0210313 doi (BORIS)oai:boris.unibe.ch:124747 610 ddc 30629665 pmid Hospital costs impact of post ischemic stroke dysphagia: Database analyses of hospital discharges in France and Switzerland [Elektronische Daten] [Natalia Muehlemann, Baptiste Jouaneton, Lucie de Léotoing, Jean-Jacques Chalé, Jérôme Fernandes, Georg Kägi, Hakan Sarikaya, Marcel Arnold] publishedVersion openAccess eu-repo INTRODUCTION: Oropharyngeal dysphagia is frequent 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 ischemic 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 the public sector. 6'037 hospital stays for stroke were analyzed from the Swiss OFS (Office fédéral de la statistique: Statistique des coûts par cas 2012) database. 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 an analysis based on diagnosis and procedure coding. Patients with post-stroke dysphagia 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) compared with patients without post-stroke dysphagia. Post-stroke dysphagia was associated with about €3'000 and CHF14'000 cost increase in France and Switzerland respectively. DISCUSSION: In this study post-stroke dysphagia was associated with increased LOS and higher hospital costs. It is difficult to isolate the impact of dysphagia in patients with multiple symptoms and disabilities impacting rehabilitation and recovery. After adjusting for confounding factors by matching stays according to age, sex and stroke complications, post-stroke dysphagia association with increased LOS and higher hospital costs was found to be independent of sensory or motor complications. CONCLUSION: Post-stroke dysphagia is associated with increased length of hospital stay and higher hospital costs. Muehlemann Natalia joint author Jouaneton Baptiste joint author de Léotoing Lucie joint author Chalé Jean-Jacques joint author Fernandes Jérôme joint author Kägi Georg joint author Sarikaya Hakan joint author Arnold Marcel joint author PLoS ONE 14(1), e0210313 1932-6203 https://boris.unibe.ch/124747/1/journal.pone.0210313.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris PeerReviewed boris peerstatus BORIS 856 40 https://boris.unibe.ch/124747/1/journal.pone.0210313.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Muehlemann Natalia joint author BORIS 700 1- Jouaneton Baptiste joint author BORIS 700 1- de Léotoing Lucie joint author BORIS 700 1- Chalé Jean-Jacques joint author BORIS 700 1- Fernandes Jérôme joint author BORIS 700 1- Kägi Georg joint author BORIS 700 1- Sarikaya Hakan joint author BORIS 700 1- Arnold Marcel joint author BORIS 773 0- PLoS ONE 14(1), e0210313 1932-6203 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess