J Korean Dysphagia Soc.  2020 Jan;10(1):97-106. 10.34160/jkds.2020.10.1.012.

Prevalence and Medical Cost under Malnutrition in Dysphagia Patients of Korea: Based on Health Insurance Review & Assessment Service (HIRA) Data

• Lee B
• Lim HS

• KMID: 2506397
• DOI: http://doi.org/10.34160/jkds.2020.10.1.012

Abstract

Objective
This study aimed to analyze the prevalence and nutritional status of patients with dysphagia using the National Health Insurance Claim database collected from all Koreans.
Methods
According to the claim data from the National Health Insurance Service from 2007 to 2017, we calculated the prevalence, comorbidity, and direct medical costs of dysphagia patients. We analyzed the difference in medical costs according to the malnutrition rate and presence of malnutrition.
Results
The prevalence of dysphagia was 635.4 per 100,000 population in 2007 but increased to 1031.6 in 2017. The proportions of type insurance showed an increasing trend in both health insurance and national free medical care, while nursing hospitals showed a significant increase of 8.46%. Esophageal and gastrointestinal disorders accounted for the highest number of diseases with dysphagia. The average medical expense per person for dysphagia was 11,984,632 Korea Won (KRW), and the average length of hospital stay was 154.1 days. The malnutrition rate of patients with dysphagia was 686.8 out of 100,000 people in 2007 to 362.9 out of 100,000 people in 2017. The malnourished group had 70.7 more inpatient hospital stays and nine more outpatient visits than the non-malnourished group.
Conclusion
The proportion of nursing hospitals and medical expenses increased significantly in the number of patients with dysphagia, and the length of hospital stay and medical costs were higher with malnutrition. As incidence of dysphagia patients may increase due to aging, active management of dysphagia is required to improve the patient’s prognosis and quality of life.

Keyword

Dysphagia; Prevalence; Malnutrition; Medical care costs