High levels of medical utilization by ambulatory patients with vocal cord dysfunction as compared to age- and gender-matched asthmatics

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.