SLEEP · 1999 · 277 citations · 12 references
MedicineInternal MedicineHealth Services ResearchResource Utilization AnalysisSleep MedicineAirway ObstructionSleep Apnea CareSleep CareSleep HealthSleep-disordered BreathingSleep-related Breathing DisordersHealth Care Utilization ManagementObstructive Sleep Apnea TherapyObstructive Sleep Apnea TreatmentSleep Apnea Syndrome
OBJECTIVE: To document changes in health care utilization (physician claims and hospitalizations) two years after diagnosis and treatment of patients with OSAS. DESIGN: Prospective observational cohort study. SETTING: The study was done in the Canadian Province of Manitoba. OSAS patients were selected from a University-based sleep disorders center. Control subjects were selected from the general population. PATIENTS AND CONTROLS: There were 344 OSAS patients on whom there was utilization data for the period of the study. They were matched to controls from the general population by gender, age, and geographic location. MEASUREMENTS AND RESULTS: The difference in physician claims between the patients and their matched controls two years after diagnosis and treatment ($174+/-32.4 (SE) per year in Canadian dollars) was significantly less than the difference in the year before diagnosis ($260+/-35.7 (SE), p=0.038). Examining the subgroups of patients adhering (PAT) or not adhering (PNAT) to treatment revealed that the changes were only significant in the patients adhering to treatment. Hospital stays for the entire OSAS group decreased from 1.27 days+0.25(SE) per patient per year one year before diagnosis to 0.54+0.13 per patient per year (p=0.01). The changes in the PAT group (1.25+0.28 per patient per year one year before diagnosis to 0.53+0.14 per patient per year (p=0.034) were significant while in the PNAT group they were not. CONCLUSIONS: Adherence to treatment in patients with OSAS results in a significant reduction in physician claims and hospital stays.
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