Patients with vocal cord dysfunction (VCD) have high medical utilization. This has been attributed to somatization, but may reflect a lack of understanding and recognition of the VCD disease process. The effect of laryngoscopic diagnosis of VCD on medical utilization has never been evaluated and results from this study will add insight into the benefit of laryngoscopy evaluation and treatment of VCD. Furthermore, the role of somatization in the pathogenesis of VCD may be better understood.
Subjects were obtained thru retrospective review of all laryngoscopies conducted in our clinic from January 2002 to March 2004. Patients with laryngoscopy confirmed VCD had their medical utilization evaluated. Inclusion required subjects to have evidence of medical utilization one year predating and one year postdating diagnosis and exclusion occurred if their diagnosis could not be confirmed by chart review. Medical utilization information for the preceding year and anteceding year were compiled from a computerized medical record. t-test analyses was utilized to compare differences between the group’s medical utilization before and after diagnosis of VCD. This study was approved by the Institutional Review Board.
Forty three ambulatory patients with VCD with a mean age of 45 (range 21-81) yearsmet inclusion criteria. Total physician visits and primary care visits were found to reduce significantly after diagnosis of VCD. These patients were also found to have comparable frequency of hospitalizations, urgent care visits, and prescriptions.
Total physician visits and primary care visits among ambulatory VCD patients are significantly reduced after diagnosis of VCD by laryngoscopic criteria.
Aggressive diagnosis of ambulatory VCD patients has a significant impact on healthcare utilization.
Jeffrey Mikita, None.Health Care MeasureYear preceding VCD diagnosis n=43Year anteceding VCD diagnosis n=43pTotal Physician Visits7966030.049*Primary Care Visits2651370.0005*Urgent Care Visits77490.084Hospitalizations1250.068Total Prescriptions767767ns