Lechien Jerome R, Leclercq Pol, Brauner Jonathan, Pirson Magali
Division of Laryngology and Bronchoesophagology, Department of Otolaryngology Head and Neck Surgery, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
Department of Otolaryngology, Elsan Polyclinic of Poitiers, Poitiers, France.
Eur Arch Otorhinolaryngol. 2024 Aug 30. doi: 10.1007/s00405-024-08881-w.
To investigate the impact of physician unawareness towards laryngopharyngeal reflux (LPR) on healthcare costs.
Patients with a confirmed LPR diagnosis were consecutively recruited from Belgian Hospitals. Demographics and clinical outcomes (impedance-pH testing features, reflux symptom score, and reflux sign assessment) were extracted. The past consultations and additional examinations dedicated to the investigation of laryngopharyngeal symptoms and findings without suspicion of LPR were collected. The estimated costs of consultations and procedures were those indicated in the National Health Insurance Institute's Charges for 2022. Part was reimbursed by the social security system, and the rest was paid by patients.
Seventy-six patients were recruited. Seventeen patients (22.4%) had no previous consultation or additional examination for their LPR-symptoms. The estimated mean (standard deviation) costs related to the unawareness of LPR for the healthcare system and patient, were 310.06 ± 370.49 €, and 54.05 ± 46.28 €, respectively. The highest estimated costs were related to gastroenterology consultations and procedures, which did not lead to a confirmation of LPR diagnosis. The total estimated cost for the Belgian healthcare system and patients (11,590,000 million), could range from 359 359 540 € to 1 078 078 620 €; and 62 643 950 € to 187 931 850 €, respectively. The estimated costs related to gastroenterology practice of patients with severe disease were significantly higher than patients with mild disease.
The unawareness of practitioners toward LPR leads to significant costs for healthcare system and patients. The teaching and awareness towards LPR need to be improved in medical schools and clinical practice.
探讨医生对喉咽反流(LPR)认识不足对医疗费用的影响。
从比利时医院连续招募确诊为LPR的患者。提取人口统计学和临床结果(阻抗-pH测试特征、反流症状评分和反流体征评估)。收集过去针对喉咽症状和发现进行的、未怀疑LPR的会诊及额外检查。会诊和检查的估计费用为国家健康保险研究所2022年收费标准所示。一部分由社会保障系统报销,其余由患者支付。
共招募76例患者。17例患者(22.4%)此前未就其LPR症状进行会诊或额外检查。医疗系统和患者因对LPR认识不足而产生的估计平均(标准差)费用分别为310.06±370.49欧元和54.05±46.28欧元。估计费用最高的是胃肠病学会诊和检查,这些并未确诊LPR。比利时医疗系统和患者的总估计费用(115.9亿)可能分别在3.5935954亿欧元至10.7807862亿欧元之间;以及6264.395万欧元至1.8793185亿欧元之间。重症患者胃肠病学诊疗的估计费用显著高于轻症患者。
从业者对LPR认识不足会给医疗系统和患者带来巨大成本。医学院校和临床实践中对LPR的教学和认知需要改进。