Peng Liu1, Shaolin Ma2, Guixiang Du3, Shengde Sun4, Xin Zhang1, Peng Tang1, Chen Hou1, Yue Liu1, Jiaxing Zhao1, Xiaohui Zhang1, Li Chen1, Chaochao Gu1, Lina Zhang1, Li Chong1, Xu Yang5, Rui Li6. 1. Vertigo and Dizziness Center, Shaanxi Provincial People's Hospital, No. 256 Youyi Rd., Xi'an, 710068, Shaanxi, People's Republic of China. 2. Clinic for Vertigo and Dizziness, Xinyuan Hospital of Yulin, Yulin, 719000, Shaanxi, People's Republic of China. 3. Clinic for Vertigo and Dizziness, The First Municipal Hospital of Weinan, Weinan, 714000, Shaanxi, People's Republic of China. 4. Otorhinolaryngology Head and Neck Surgery, Wuwei People's Hospital, Wuwei, 733000, Gansu, People's Republic of China. 5. Department of Neurology, Aerospace Center Hospital, Aerospace Clinical Medical College of Peking University, Beijing, 100049, People's Republic of China. 6. Vertigo and Dizziness Center, Shaanxi Provincial People's Hospital, No. 256 Youyi Rd., Xi'an, 710068, Shaanxi, People's Republic of China. lrmail@yeah.net.
Abstract
BACKGROUND: Single disciplinary management of patients with vertigo and dizziness is an important challenge for most physicians in China. OBJECTIVE: To assess the impact of a new paradigm of practice (Clinic for Vertigo and Dizziness, CVD) performed by a multidisciplinary team (MDT) on diagnostic spectrum, medical costs, and patient satisfaction. DESIGN: Retrospective before-after study. PARTICIPANTS: Sample of 29,793 patients with vertigo/dizziness as primary complaint. MEASURES: Changes in diagnostic spectrum, medical costs, and patient satisfaction before and after the establishment of a CVD based on a 4-year database in three tertiary hospitals in northwestern China. KEY RESULTS: The most common diagnoses of patients with vertigo and dizziness were Meniere's disease (25.77%), cervical disease (25.00%), cerebral vascular disease (13.96%), vestibular syndrome (10.57%), and other etiologies (6.34%) before the CVD establishment. In contrast, after the CVD establishment, the most common diagnoses were BPPV (23.92%), vestibular migraine (15.83%), Meniere's disease (14.22%), CSD/PPPD (11.61%), and cerebral vascular diseases (4.45%). Extended implementation of a structured questionnaire for vertigo/dizziness and vestibular-oriented examinations (nystagmus, positional tests, HINTS) at the CVD resulted in a remarkable decline in the utility of CT/MRI and X-ray examination (p < 0.001). Meanwhile, medical costs in patients with vertigo/dizziness dropped by 11.5% (p < 0.001), with a significant improvement in patient satisfaction after the establishment of CVD (p < 0.001). CONCLUSIONS AND RELEVANCE: Our study suggested that the MDT paradigm of CVD practice may facilitate the medical management of patients with vertigo/dizziness and improve patient satisfaction.
BACKGROUND: Single disciplinary management of patients with vertigo and dizziness is an important challenge for most physicians in China. OBJECTIVE: To assess the impact of a new paradigm of practice (Clinic for Vertigo and Dizziness, CVD) performed by a multidisciplinary team (MDT) on diagnostic spectrum, medical costs, and patient satisfaction. DESIGN: Retrospective before-after study. PARTICIPANTS: Sample of 29,793 patients with vertigo/dizziness as primary complaint. MEASURES: Changes in diagnostic spectrum, medical costs, and patient satisfaction before and after the establishment of a CVD based on a 4-year database in three tertiary hospitals in northwestern China. KEY RESULTS: The most common diagnoses of patients with vertigo and dizziness were Meniere's disease (25.77%), cervical disease (25.00%), cerebral vascular disease (13.96%), vestibular syndrome (10.57%), and other etiologies (6.34%) before the CVD establishment. In contrast, after the CVD establishment, the most common diagnoses were BPPV (23.92%), vestibular migraine (15.83%), Meniere's disease (14.22%), CSD/PPPD (11.61%), and cerebral vascular diseases (4.45%). Extended implementation of a structured questionnaire for vertigo/dizziness and vestibular-oriented examinations (nystagmus, positional tests, HINTS) at the CVD resulted in a remarkable decline in the utility of CT/MRI and X-ray examination (p < 0.001). Meanwhile, medical costs in patients with vertigo/dizziness dropped by 11.5% (p < 0.001), with a significant improvement in patient satisfaction after the establishment of CVD (p < 0.001). CONCLUSIONS AND RELEVANCE: Our study suggested that the MDT paradigm of CVD practice may facilitate the medical management of patients with vertigo/dizziness and improve patient satisfaction.
Authors: Neil Bhattacharyya; Samuel P Gubbels; Seth R Schwartz; Jonathan A Edlow; Hussam El-Kashlan; Terry Fife; Janene M Holmberg; Kathryn Mahoney; Deena B Hollingsworth; Richard Roberts; Michael D Seidman; Robert W Prasaad Steiner; Betty Tsai Do; Courtney C J Voelker; Richard W Waguespack; Maureen D Corrigan Journal: Otolaryngol Head Neck Surg Date: 2017-03 Impact factor: 3.497
Authors: R Teggi; M Manfrin; C Balzanelli; O Gatti; F Mura; S Quaglieri; F Pilolli; L O Redaelli de Zinis; M Benazzo; M Bussi Journal: Acta Otorhinolaryngol Ital Date: 2016-06 Impact factor: 2.124