Measuring Dysphagia Outcomes

抄録

It is my distinct pleasure to return to Japan．In particular，it is an honor to once again address the Japanese Society of Dysphagia Rehabilitation．Much has happened in four years．In discussions I have had with your colleagues，it is clear to me that this Society has made great strides toward educating medical personnel，and dysphagic patients and their families about the diagnosis and treatment of the dysphagic condition．I would congratulate the planning committee for the selection of this years’ theme，“the right to eat”．Personally，I have made a philosophical，but I think medically relevant change in my own thinking about dysphagia treatment． Rather than emphasizing the need to prevent aspiration pneumonia，our focus should be on allowing patients to continue eating in the safest manner possible，The implication of this philosophical stance is that we must take very seriously the impact of taking away a patient's right to oral alimentation． In the United States，dysphagia services are paid for by insurance companies．The regulation of the policies for financial reirnbursement is monitored by the Health Care Financing Administration．This group has asked the American Speech，Language，and Hearing Association to provide outcome data on the benefit of our services with dysphagic patients．Unfortunately，there are few data on this subject．To gather the data we have to decide what to measure and how to measure it．What I will talk about today is our preliminary thinking on this topic．