This thesis explores the economic consequences of dysphagia, a debilitating disorder characterised by impaired swallowing function, in New Zealand. By analysing various dimensions of this disorder, including its prevalence, economic burden, and the effectiveness of performance-based arrangements to increase uptake of new interventions, I provide a comprehensive understanding of dysphagia in New Zealand from an economic perspective.

I draw on existing literature to estimate that 1.5% (1.1%–2.0%) of the total New Zealand population lived with the effects of dysphagia in 2020 and I project this to increase to 2.6% (2.0%–3.5%) by 2073. Using hospitalisation data from the Canterbury District Health Board (CDHB), I find that the presence of dysphagia in a hospital stay, relating to any primary condition, increases the total cost of hospitalisation on average by 56%. Through the REGIONS Care national research data, I estimate new onset stroke-related dysphagic patients in 2021 to present a total additional cost of $24,200 per patient, or $77.2 million overall, to New Zealand society. The increasing prevalence of dysphagia alongside the condition’s large cost will likely result in a major financial burden on the New Zealand healthcare system. Medical interventions designed to aid in the treatment or management of dysphagic patients could lead to significant future cost avoidance.

I then explore the potential of Performance-Based Risk-Sharing Arrangements as a mechanism to mitigate the financial risks associated with dysphagia. Through an insurance framework, I show how these arrangements present a potential solution to increase the chance of new healthcare interventions being adopted and funded by healthcare payers and/or providers. My research lays a solid groundwork for policymakers, healthcare providers, and researchers to develop targeted interventions, optimise resource allocation, and enhance the well-being of individuals impacted by dysphagia.