The Economic Burden of Vertigo: Results From the Hospitalized and Outpatients

Abstract

Objective: Vertigo and dizziness are the common presenting concerns in emergency departments and outpatient clinics, accounts for approximately 15% to 20% of adults annually. We aimed to evaluate economic burden of vertigo on health-care system and work productivity in association between clinic characteristics of in- or outpatients. Methods: A total number of 2289 patients diagnosed with peripheric (noncentral) vertigo were evaluated retrospectively. The direct medical costs associated with vertigo classified as medication, consumable, imaging, and laboratory. In addition, the indirect costs were associated with lost working days. The overall economic impact of vertigo assessed via total expenditure for diagnosis and treatment. Results: The mean duration of hospitalization was 5.6 ± 4.3 days and working day lost was 9.47 ± 3.90 days. The overall impact on work productivity of disease was 15.35 ± 6.11 days. The overall mean direct cost including all expenditure items associated with vertigo care was $250.25 ± $1479.62 per patient. The overall cost associated with vertigo was found to be statistically increased in the male, aged ≥65 years, widow or divorced, and hospitalized patients. Conclusions: Our findings clearly indicate that a vertigo–dizziness management program based on patients’ risk factors may achieve to reduce hospitalizations and cost of hospital care as well.

Do Vestibular Physiotherapy and a Clinical Pathway in the Emergency Department Improve Management of Vertigo?

“…Ozdemir et al evaluated the economic burden of vertigo on the health care system and found that mean duration of hospitalization of peripheral vertigo was 5.6 days with high associated costs, far greater than the 5.2-hour hospital LOS found in this study. 19 This study aimed to move patient care toward the ambulatory setting for diagnosed peripheral conditions, but this aim was not achieved with the implemented vertigo clinical pathway, as recorded by the unchanged admission rates and total hospital LOS. A possible explanation is that the processes to move a patient to quick follow-up ambulatory care were too complex.…”

Migraine management for the otolaryngologist

“…[12][13][14] Patients who suffer from vestibular migraine are more disabled with lower health-related quality of life than migraineurs without vestibular symptoms. 10,12,15,16 3 | PATHOPHYSIOLOGY Migraine attacks are thought to occur in multiple phases: premonitory phase, trigeminal activation, cortical spreading depression, and sustained inflammation. 17 Activation of the trigeminal neurovascular complex is considered a forefront mechanism underlying migraine 1 and is mediated by endogenous signaling neuropeptides inducing neurogenic and meningeal inflammation.…”

“…Median age of vestibular migraine onset is quoted between 30 and 40 years, and women are affected three times more than men 12–14 . Patients who suffer from vestibular migraine are more disabled with lower health‐related quality of life than migraineurs without vestibular symptoms 10,12,15,16 …”

Balance Disorder Trends in US Adults 2008‐2016: Epidemiology and Functional Impact

“…These quality of life impacts may be even more pronounced among older patients, 9 for whom dizziness can be particularly prohibitive in participating in activities of daily living 10 . And even in younger adults, dizziness and balance disorders can negatively impact economic productivity—for example, many (70%) patients with vertigo report having to decrease their workload overall 11 and even reported missing an average of over 2 weeks at work due to their diagnosis 12 …”

“…10 And even in younger adults, dizziness and balance disorders can negatively impact economic productivity-for example, many (70%) patients with vertigo report having to decrease their workload overall 11 and even reported missing an average of over 2 weeks at work due to their diagnosis. 12 In order to study the epidemiology of dizziness and balance disorders across adults in the United States, we used data from the National Health Interview Survey, which is conducted through personal household interviews by the United States Census Bureau in order to better understand health care access and health status on a national level. Our goal was to quantify the changes in prevalence and impact of dizziness and balance disorders in the adults in the United States from 2008 to 2016.…”