Unmanaged dysphagia exposes patients to risk of malnutrition, dehydration, urinary tract infections (UTI) and aspiration pneumonia. It has been demonstrated that dysphagia screening and management may reduce the risk of developing complications and incurring increased hospital charges. The objective of this analysis is to quantify the additional charges associated with common complications of dysphagia.

Using 2008 Health Care Utilization Project (HCUP) data, individuals with a recorded diagnosis of dysphagia (ICD-9 CM: 438.82, 787.2-787.29) were identified. The mean (10% trimmed) hospital charges for individuals with and without a recorded comorbid diagnosis of malnutrition, dehydration, UTI and aspiration pneumonia were compared. As there was a significant interaction between number of comorbidities and hospital charge in the UTI and pneumonia sample, an analysis of covariance (ANCOVA) model was employed to adjust the UTI and pneumonia analyses for this influence. The model was adjusted for complication diagnosis as a factor and both 1) number of comorbidities, and 2) complication diagnosis and number of comorbidities interaction as covariates.

The most common complications reported in patients with a recorded diagnosis of dysphagia were UTI (27%, n=3424), pneumonia (26%, n=3348), dehydration (12%, n=1507), and malnutrition (8%, n=1027). Dysphagia patients with complications had significantly higher mean hospital charges than those without the complications UTI ($35,358 vs. $30,373, p<0.001), pneumonia ($33,085 vs. $31,184, p<0.001), dehydration ($28,093 vs. $20,850, p<0.001), and malnutrition ($37,192 vs. $34,747, p<0.001), and MS ($32,406 vs. $23,726, p<0.001).

Our results demonstrate that having to treat the complications of dysphagia adds significantly to the cost of hospital care. Proactive management of patients with dysphagia may confer substantial savings to hospitals.