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Management of Obstructive Sleep Apnea and Its Effect on Health-care Resource Utilization
October 2010, Vol 138, No. 4_MeetingAbstracts Slide Presentations: Monday, November 1, 2010 | October 2010
Management of Obstructive Sleep Apnea and Its Effect on Health-care Resource Utilization Robert J. Walter, MD; Scott Hagedorn, MD; Christopher J. Lettieri, MD Walter Reed Army Medical Center, Washington, DC Chest. 2010;138(4_MeetingAbstracts):783A. doi:10.1378/chest.10587 Abstract PURPOSE: Obstructive Sleep Apnea (OSA) is a common medical condition that is associated with substantial increases in healthcare resource utilization as well as an additional $3.4 billion medical cost annually. Limited studies have analyzed the overall impact on healthcare utilization. The purpose of this study was to determine the prevalence of co-morbid conditions associated with OSA and the impact of CPAP treatment on healthcare resource utilization. METHODS: We conducted a retrospective study of patients newly diagnosed with OSA initiated on CPAP. The primary endpoint was a change in healthcare resource utilization. The total number of outpatient encounters (patient, physician and non-physician), medications, labs as well as an overall index for healthcare utilization (labs, medications, physician encounters) were reviewed within the 12 months prior to and 12 months following initiation of CPAP. The outpatient medical record was also surveyed to establish the prevalence of several commonly associated co-morbid conditions. RESULTS: In a study of 403 patients, the mean age was 47.2 8.8 years, 77.6% male. Of the associated co-morbid conditions analyzed, the following prevalences were identified: diabetes mellitus (16%), hyperlipidemia (56.6%), hypertension (50.4%), depression (20.3%), asthma (8.0%), GERD (39.1%), rhinitis (54.9%), coronary artery disease (6.8%), and chronic pain syndromes (19.1%).Following the initiation of CPAP, a statistically significant reduction in labs (18.3%, p = 0.02), non-sleep physician encounters (16.9%, p = 0.01), and overall index for healthcare utilization (14.9%, p = 0.01) was observed. In addition, a non-statistically significant reduction in medications (9.1%, p = 0.20) and physician outpatient encounters (12.5%, p = 0.08) was demonstrated. CONCLUSION: Management of OSA with CPAP resulted in a statistically significant decrease in several markers for healthcare resource utilization; specifically, it demonstrated a reduction in the number labs, non-sleep physician encounters, and our overall index of healthcare utilization. CLINICAL IMPLICATIONS: CPAP may be a cost-effective means of decreasing healthcare resource utilization resulting in reduction in the overall fiscal burden associated with this condition and its co-morbidities. DISCLOSURE: Robert Walter, No Financial Disclosure Information; No Product/Research Disclosure Information 4:30 PM - 06:00 PM
Management of Obstructive Sleep Apnea and Its Effect on Health-care Resource Utilization Robert J. Walter, MD; Scott Hagedorn, MD; Christopher J. Lettieri, MD Walter Reed Army Medical Center, Washington, DC Chest. 2010;138(4_MeetingAbstracts):783A. doi:10.1378/chest.10587 Abstract PURPOSE: Obstructive Sleep Apnea (OSA) is a common medical condition that is associated with substantial increases in healthcare resource utilization as well as an additional $3.4 billion medical cost annually. Limited studies have analyzed the overall impact on healthcare utilization. The purpose of this study was to determine the prevalence of co-morbid conditions associated with OSA and the impact of CPAP treatment on healthcare resource utilization. METHODS: We conducted a retrospective study of patients newly diagnosed with OSA initiated on CPAP. The primary endpoint was a change in healthcare resource utilization. The total number of outpatient encounters (patient, physician and non-physician), medications, labs as well as an overall index for healthcare utilization (labs, medications, physician encounters) were reviewed within the 12 months prior to and 12 months following initiation of CPAP. The outpatient medical record was also surveyed to establish the prevalence of several commonly associated co-morbid conditions. RESULTS: In a study of 403 patients, the mean age was 47.2 8.8 years, 77.6% male. Of the associated co-morbid conditions analyzed, the following prevalences were identified: diabetes mellitus (16%), hyperlipidemia (56.6%), hypertension (50.4%), depression (20.3%), asthma (8.0%), GERD (39.1%), rhinitis (54.9%), coronary artery disease (6.8%), and chronic pain syndromes (19.1%).Following the initiation of CPAP, a statistically significant reduction in labs (18.3%, p = 0.02), non-sleep physician encounters (16.9%, p = 0.01), and overall index for healthcare utilization (14.9%, p = 0.01) was observed. In addition, a non-statistically significant reduction in medications (9.1%, p = 0.20) and physician outpatient encounters (12.5%, p = 0.08) was demonstrated. CONCLUSION: Management of OSA with CPAP resulted in a statistically significant decrease in several markers for healthcare resource utilization; specifically, it demonstrated a reduction in the number labs, non-sleep physician encounters, and our overall index of healthcare utilization. CLINICAL IMPLICATIONS: CPAP may be a cost-effective means of decreasing healthcare resource utilization resulting in reduction in the overall fiscal burden associated with this condition and its co-morbidities. DISCLOSURE: Robert Walter, No Financial Disclosure Information; No Product/Research Disclosure Information 4:30 PM - 06:00 PM