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(Chest. 2006;129:905-908.)
© 2006 American College of Chest Physicians

High Levels of Medical Utilization by Ambulatory Patients With Vocal Cord Dysfunction as Compared to Age- and Gender-Matched Asthmatics*

Jeffrey Mikita, MD and Joseph Parker, MD

* From the Department of Medicine, Walter Reed Army Medical Center, Washington, DC, and the Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD.

Correspondence to: Jeffrey Mikita, MD, Walter Reed Army Medical Center, Department of Medicine, Pulmonary Disease Services, 6900 Georgia Ave, NW, Washington, DC 20307; e-mail: jeffrey.a.mikita{at}us.army.mil

Abstract

Study objectives: To evaluate medical utilization by ambulatory patients with vocal cord dysfunction (VCD).

Design: Retrospective, case-control study.

Setting: Pulmonary disease clinic at an army tertiary-care center.

Patients: Twenty-five ambulatory patients with VCD (mean age, 41 years; range, 27 to 69 years) who were age- (± 3 years) and gender-matched to 25 control patients with moderate persistent asthma.

Measurements and results: Medical utilization for the year preceding the diagnosis of VCD or asthma was obtained from a computerized medical record. End points included total outpatient visits, evaluations by subspecialty physicians, presentations for urgent care, hospitalizations, and number of prescriptions. Total physician visits (477 visits vs 267 visits, respectively; p < 0.004) and subspecialty care visits (277 visits vs 118 visits; p < 0.007) were significantly greater among the VCD cohort as compared with the asthmatic cohort. The groups were also found to have comparable utilization of prescriptions (448 prescriptions vs 394 prescriptions, respectively; p < 0.63), frequency of hospitalizations (seven hospitalizations vs five hospitalizations; p < 0.59), and urgent care visits (45 visits vs 20 visits; p < 0.14).

Conclusions: Ambulatory VCD patients use significantly more medical provider resources and similar pharmaceutical assets as compared to patients with moderate persistent asthma.

Key Words: ambulatory care • asthma • dyspnea • vocal cords




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K. L. Christopher
Understanding vocal cord dysfunction: a step in the right direction with a long road ahead.
Chest, April 1, 2006; 129(4): 842 - 843.
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