| 류정숙, 조용근,배명환,권용섭,이장훈,류현민,양동헌,박헌식,채성철,전재은,박의현 |
Background: Healthcare cost has incurred a tremendous increase in recent years. The cost per diagnosis of any disease accounts for an important part of such expense. Syncope is one of diseases, which need to expensive cost and long time until diagnosis. The aim of this study was to assess the cost and duration until performing head-up tilt test (HUTT) for diagnosis of syncope. Methods: In this prospective study, we investigated clinical histories and cost of the patients performing HUTT for diagnosis of syncope from February 28, 2008 to July 18, 2008. Results: Fifty-five patients (29 males, mean age 45 years old, range: 13-79) were studied and 91% of patients visited after evaluation in local clinic including neurology and/or oriental medicine clinic. Mean age of first episode of syncope was 38 years old (range: 9-79) and mean frequency of syncope was 4.8 events (range: 1-45). Thirteen patients had family history of syncope and eleven patients had hypertension. The cost and duration until performing HUTT were 580,867 won (range: 110,000-1,800,000) and 72 months (range: 0.1-540), respectively. Sex, age, history of hypertension and family history of syncope were not significantly associated with the cost and duration until performing HUTT. Stepwise multivariate linear regression analysis showed the number of total episodes of syncope (β=0.244, P=0.011) was an independent determinant of duration until performing HUTT. Echocardiography and 24h Holter monitoring was performed in 63% and 60% of the patients and 16% of the patients underwent brain imaging including brain MRI or CT. The cost of 6 patients performed brain MRI was higher than those who did not (1,101,666 ± 356,618 won vs. 518,560 ± 299,468 won, P=0.001). Positive results of HUTT were in 31 patients but these results were not significantly associated with the cost (P=0.855) and duration (P=0.440) until performing HUTT. Conclusion: Syncope until performing HUTT for diagnosis has need of high cost and long duration, although the range of cost and duration varies widely.
|
