Utilization of Healthcare Resources in Obstructive Sleep Apnea Syndrome: a 5- Year Follow-Up Study in Men Using CPAP

Mohammed Albarrak, MD, D,ABSM1; Katsuhisa Banno, MD1; Ahmed Al. Sabbagh, MD, FRCPC1; Kenneth Delaive, BSc1; Randy Walld, BSc2; Jure Manfreda, MD2 ;Meir H. Kryger, MD, FRCPC

1Sleep Disorders Center, St. Boniface General Hospital, Section of Respiratory Diseases, and 2Manitoba Centre for Health Policy and Evaluation, University of Manitoba, Winnipeg, Manitoba, Canada

Study Objectives: Patients with untreated obstructive sleep apnea syndrome (OSAS) have higher healthcare utilization than matched controls. However, the long-term impact of continuous positive airway pressure () use on healthcare utilization is unknown.

Design: Retrospective observational cohort study.

Subjects: There were 342 eligible men with OSAS and matched controls on whom there were utilization data for 5 years prior to initial OSAS diagnosis and for the 5 years on CPAP treatment of the cases.

Interventions: Patients were treated with CPAP. Results: Patients with OSAS were typical cases (mean±SD): age, 48.2±0.6 years; body mass index, 35.6±0.4 kg/m2; Epworth Sleepiness Scale score, 14.2±0.3; apnea-hypopnea index, 47.1±1.8 events per hour. The number of physician visits were higher by 3.46±0.2 (95% confidence interval [CI]:2.57 to 4.36) in cases in the year before diagnosis, compared with the fifth year before diagnosis, then decreased over the next 5 years by 1.03±0.49 (95% CI: -1.99 to -0.07)(P<.0001). Physician fees, in Canadian dollars, were higher by $148.65±$27.27(95% CI: 95.12 to 202.10) in cases in the year before diagnosis, compared with the fifth year before diagnosis, and then decreased over the next 5 years by $13.92±$27.94(95%CI: -68.68 to 40.83)(P=.0009). Preexisting ischemic heart disease at the time of OSAS diagnosis predicted about a 5-fold increase in healthcare utilization between the second and fifth year of treatment.

Conclusions: Treatment of OSAS reversed the trend of increasing healthcare utilization seen prior to diagnosis. Preexisting ischemic heart disease results in a negative impact on healthcare utilization. CPAP results in a long-term health benefit, as measured by the use of healthcare services.

Keywords: Sleep, apnea, medical economics, epidemiology, healthcare utilization, CPAP compliance

Citation: Albarrak M; Banno K; Sabbagh AA et al. Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP. SLEEP 2005;28(10): 1306-1311.

Full Text http://www.journalsleep.org/Articles/281019.pdf

Randy Clare

Randy Clare

Randy Clare brings to The Sleep and Respiratory Scholar more than 25 years of extensive knowledge and experience in the sleep and pulmonary function field. He has held numerous management positions throughout his career and has demonstrated a unique view of the alternate care diagnostic and therapy model. He is considered by many an expert in the use of a Sleep Bruxism Monitor in a dental office. Mr. Clare's extensive sleep industry experience assists Sleepandrespiratoryscholar in providing current, relevant, data-proven information on sleep diagnostics and sleep therapies that are effective for the treatment of sleep disorders. Mr Clare is a senior brand manager for Glidewell Dental Laboratory his focus is on dental treatment for sleep disordered breathing.

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