Economic Evaluation of Clinical, Nutritional and Rehabilitation Interventions on Oropharyngeal Dysphagia after Stroke : A Systematic Review
Marin, Sergio ![Identificador ORCID](/img/uab/orcid.ico)
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ortega, Omar ![Identificador ORCID](/img/uab/orcid.ico)
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Serra-Prat, Mateu ![Identificador ORCID](/img/uab/orcid.ico)
(Hospital de Mataró. Consorci Sanitari del Maresme)
Valls, Ester ![Identificador ORCID](/img/uab/orcid.ico)
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pérez-Cordón, Laia ![Identificador ORCID](/img/uab/orcid.ico)
(Hospital de Mataró. Consorci Sanitari del Maresme)
Clavé i Civit, Pere ![Identificador ORCID](/img/uab/orcid.ico)
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona
Data: |
2023 |
Resum: |
Background: Post-stroke oropharyngeal dysphagia (PS-OD) and its complications increase healthcare costs, suggesting that its appropriate management is cost-effective. We aimed to assess the efficiency of healthcare interventions in PS-OD management. Methods: A systematic review was conducted following PRISMA recommendations. Four databases were searched from inception through 30 June 2021. Outcome measures were cost-effectiveness and cost-savings of healthcare interventions. English and Spanish literature were included. Narrative and tables were used to present and synthesise evidence. Quality was evaluated using the CHEERS Statement. Results: A total of 244 studies were identified, and 10 were included. Screening and diagnosis of PS-OD studies found: (1) adjusted reduction in hospitalisation costs when assessed during the first admission day; (2) non-significant reduction in hospitalisation costs with OD management after thrombolysis; and (3) videofluoroscopy as the most cost-effective screening method (compared to bedside evaluation and a combination of both). Two studies showed cost-effective rehabilitation programmes, including OD management. Pelczarska et al. showed an incremental cost-utility ratio of texture-modified diets using a gum-based thickener of 20,977 PLN (4660€) following a dynamic model, and Kotecki et al. commercially prepared thickened fluids that were 44% to 59% less expensive than in situ prepared fluids. Elia et al. showed home enteral nutrition was cost-effective (£12,817/QALY), and Beavan et al. showed higher nutrient intake and low increase in hospitalisation costs using looped-nasogastric tubes (£5. 20 for every 1% increase). Heterogeneity between studies precluded a quantitative synthesis. Conclusions: Included studies suggest that healthcare interventions aiming to prevent OD complications are cost-effective. However, studies assessing novel strategies are needed. |
Ajuts: |
Instituto de Salud Carlos III PI22/01101 Instituto de Salud Carlos III ICI20/00117
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Drets: |
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Llengua: |
Anglès |
Document: |
Article ; recerca ; Versió publicada |
Matèria: |
Brain ischemia/complications ;
Cerebral haemorrhage ;
Deglutition disorders ;
Economics ;
Health resources ;
Nutrition therapy ;
Stroke ;
Systematic review |
Publicat a: |
Nutrients, Vol. 15 (march 2023) , ISSN 2072-6643 |
DOI: 10.3390/nu15071714
PMID: 37049553
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Registre creat el 2023-08-01, darrera modificació el 2023-10-01