The economic burden of vertigo and dizziness in the United States

Article type: Research Article

Authors: Ruthberg, Jeremy S.^a | Rasendran, Chandruganesh^a | Kocharyan, Armine^b | Mowry, Sarah E.^{a; b} | Otteson, Todd D.^{a; b}

Affiliations: [a] Case Western Reserve University School of Medicine, Cleveland, OH, USA | [b] Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA

Correspondence: [*] Corresponding author: Sarah E. Mowry, Ear Nose and Throat Institute, University Hospitals of Cleveland/Rainbow Babies and Children’s Hospital, 11100 Euclid Ave, Cleveland, OH 44106, USA. Tel.: +1 216 844 6000; E-mail: [email protected].

Abstract: BACKGROUND:Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE:Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS:A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS:Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p < 0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION:Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.

Keywords: Otolaryngology, vertigo, dizziness, economic burden, incremental burden

DOI: 10.3233/VES-201531

Journal: Journal of Vestibular Research, vol. 31, no. 2, pp. 81-90, 2021