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Published on: March 1, 2015
Cost analysis of post-stroke dysphagia during acute hospitalisation: a cross-sectional study in Vietnam
Tran Huu Thong1,2,3, Nguyen Thi Thu Hien4,5,6, Le Thanh Tung6
1Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam.
Objectives:
To estimate the healthcare costs associated with post-stroke dysphagia during acute hospitalisation and to identify factors influencing these costs in a tertiary hospital setting in Vietnam.
Design:
A cross-sectional study using clinical and billing data from hospital records.
Setting:
The study was conducted at the Neurology Center of Bach Mai Hospital, a tertiary care facility in Hanoi, Vietnam, between June 2020 and January 2022.
Participants:
A total of 951 patients aged ≥18 years with acute ischaemic stroke confirmed by CT or MRI were included. Dysphagia was assessed using the Gugging Swallowing Screen.
Outcome Measures:
Direct healthcare costs during hospitalisation were collected from the hospital billing system and categorised as medications, diagnostic imaging, medical supplies, accommodation, food, procedures and laboratory tests. All costs were converted to USD. Associations between patient characteristics and total healthcare costs were analysed using generalised linear models (Gamma distribution with log link), applying robust standard errors.
Results:
The median treatment cost was 10.08 million VND (436.24 USD) in the dysphagia group vs 6.37 million VND (275.78 USD) in the non-dysphagia group. Costs increased with dysphagia severity, reaching 22.64 million VND (979.49 USD) among patients with severe dysphagia. In multivariate analysis, dysphagia was associated with a 21% increase in costs (exp(β) = 1.21; 95% CI 1.10 to 1.33; p<0.01). Other significant cost drivers included combined stroke lesions, National Institute of Health Stroke Scale score >14, pneumonia, prolonged hospitalisation and higher educational level.
Conclusions:
Post-stroke dysphagia substantially increases acute hospitalisation costs in Vietnam. Early screening, standardised management and preventive care for complications may improve outcomes and reduce costs.
Trial Registration Number:
The study was registered on the Research Registry website (https://www.researchregistry.com/) under the unique identification number: researchregistry8203.
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