{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:41:15Z","timestamp":1761007275406,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To report the odds of dysphagia treatment among adults with self\u2010reported dysphagia before and after the implementation of the Affordable Care Act (ACA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National Health Interview Survey (NHIS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 490 million individuals from the 2012 and 2022 NHIS in weighted responses. Among 235 million individuals in 2012, 9.4 million (4.0%) reported dysphagia (median age, 56.0 years; interquartile range [IQR], 40.0\u201068.0 years; 60% female). Among 255 million adults in 2022, 15 million (5.9%) reported dysphagia (median age, 58.0 years; IQR, 40.0\u201071.0 years; 57% female). After adjusting for sociodemographic factors, adults in 2022 were significantly more likely than those in 2012 to report dysphagia (adjusted odds ratio [aOR], 1.64; CI, 1.43\u20101.87). However, there was no significant difference in the odds of reporting dysphagia treatment between 2012 and 2022. Subgroup analyses by age, race and ethnicity, and insurance type also revealed no significant differences when comparing the 2012 and 2022 cohorts. When examining general access to care, adults reporting dysphagia in 2022 were significantly less likely to delay medical care due to the cost compared to adults reporting dysphagia in 2012 (aOR, 0.52; 95% CI, 0.43\u20100.62).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although more adults reported dysphagia in 2022 than in 2012, our results show no significant improvement in access to dysphagia treatment. This suggests that, although the ACA reduced cost\u2010related barriers, it has not adequately addressed access to dysphagia care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1239","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T10:20:17Z","timestamp":1743589217000},"page":"162-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0345-2756","authenticated-orcid":false,"given":"Robin","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sean Parker Institute for the Voice, Weill Cornell Medical College New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linh","family":"He","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sean Parker Institute for the Voice, Weill Cornell Medical College New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara W.","family":"Albert","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sean Parker Institute for the Voice, Weill Cornell Medical College New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sean Parker Institute for the Voice, Weill Cornell Medical College New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-2634","authenticated-orcid":false,"given":"Ana\u00efs","family":"Rameau","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sean Parker Institute for the Voice, Weill Cornell Medical College New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30786-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.8421"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2011\/14\/E35"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.focus.2022.100027"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.0798"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3376-3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/03601277.2013.766518"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814549156"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1044\/2020_JSLHR-19-00270"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29325"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2022.103774"},{"key":"e_1_2_8_13_1","unstructured":"NHIS\u2014National Health Interview Survey. Centers for Disease Control and Prevention. October 17 2024. Accessed October 21 2024.https:\/\/wwwcdc.gov\/nchs\/nhis\/index.htm"},{"volume-title":"R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing","year":"2023","author":"R Core Team","key":"e_1_2_8_14_1"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1044\/2024_AJSLP-23-00407"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-023-08232-1"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/17549507.2021.1912179"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31495"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0898264316659994"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-020-00402-5"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2015.04.001"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-07829-2"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0314620"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10386-1"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-022-10444-2"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-022-10544-z"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000001117"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S371624"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489420916215"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-018-09971-8"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/17571472.2014.11494366"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-013-9467-8"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.10.029"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-023-02499-4"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-086184"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.1239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:24:18Z","timestamp":1760963058000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.1239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/ohn.1239"],"URL":"https:\/\/doi.org\/10.1002\/ohn.1239","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}