Aviv J E, Sataloff R T, Cohen M, Spitzer J, Ma G, Bhayani R, Close L G
Department of Otolaryngology-Head and Neck Surgery, New York Presbyterian Hospital and College of Physicians and Surgeons, Columbia University, New York City, USA.
Ear Nose Throat J. 2001 Aug;80(8):553-6, 558.
We conducted a prospective, preliminary study to compare the cost-effectiveness of two different instrument-based techniques for diagnosing and managing dysphagia in 30 consecutive hospitalized patients with head and neck cancer. The two techniques are videofluoroscopy via modified barium swallow (MBS) and videoendoscopy via flexible endoscopic evaluation of swallowing with sensory testing (FEESST). Medicare was the primary insurer of all patients. Fifteen of these patients had their dysphagia diagnosed and managed by MBS and the other 15 by FEESST. Cost-effectiveness was assessed by determining the average Medicare reimbursement for each procedure. We found that the mean reimbursements were $451.01 (+/- $50.55) for MBS and $321.23 (+/- $3.01) for FEESST. The mean reimbursement for FEESST was significantly lower than that for MBS (p < 0.0001; Mann-Whitney U test). We conclude that FEESST appears to be more cost-effective than MBS for the inpatient management of dysphagia in patients with head and neck cancer.
我们进行了一项前瞻性初步研究，以比较两种不同的基于仪器的技术在连续30例头颈部癌住院患者中诊断和管理吞咽困难的成本效益。这两种技术分别是改良钡剂吞咽造影（MBS）视频荧光吞咽造影和经感觉测试的吞咽功能内镜评估（FEESST）视频内镜检查。医疗保险是所有患者的主要保险。其中15例患者通过MBS诊断和管理吞咽困难，另外15例通过FEESST诊断和管理。通过确定每个程序的平均医疗保险报销额来评估成本效益。我们发现，MBS的平均报销额为451.01美元（±50.55美元），FEESST的平均报销额为321.23美元（±3.01美元）。FEESST的平均报销额显著低于MBS（p<0.0001；曼-惠特尼U检验）。我们得出结论，对于头颈部癌患者吞咽困难的住院管理，FEESST似乎比MBS更具成本效益。
