抄録
The growth of the elderly population has led to an increased prevalence of dysphagia. Percutaneous endoscopic gastrostomy (PEG) performed by gastroendoscopists is indicated for severe dysphagia. The indications for PEG must be based on an appropriate evaluation of swallowing, now more important because of the revised medical payment system. Swallowing function is often evaluated by otolaryngologists, but many small and medium-sized hospitals have no otolaryngologists. In our hospital, gastroendoscopists use videoendoscopic evaluation of swallowing (VE) to evaluate swallowing function.
VE was performed in patients with suspected dysphagia. VE images were evaluated using Hyodo’s scoring system to determine indications for PEG.
Accurate swallowing evaluations enabled appropriate indications for PGE to be determined. The remuneration for PEG has decreased from 10,070 to 6,070 points. However, when PEG was performed after VE and esophagogastroduodenoscopy, the remuneration increased to 9,710 points, nearly equivalent to the previous value.
Gastroendoscopists are proficient in endoscopic examinations and can easily master VE techniques. VE is useful for determining the indications for PEG and may be necessary from the viewpoint of healthcare economics. Gastroenterologists should evaluate swallowing function.
