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0508 Association of Positive Airway Pressure Use with Acute Care Utilization and Costs

Sleep (New York, N.Y.), 2019-04, Vol.42 (Supplement_1), p.A203-A204 [Peer Reviewed Journal]

Sleep Research Society 2019. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com. ;ISSN: 0161-8105 ;EISSN: 1550-9109 ;DOI: 10.1093/sleep/zsz067.506

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  • Title:
    0508 Association of Positive Airway Pressure Use with Acute Care Utilization and Costs
  • Author: Kirsch, Douglas B ; Yang, Hongmei ; Maslow, Andrea ; Stolzenbach, Michael ; McCall, Andrea
  • Subjects: Costs
  • Is Part Of: Sleep (New York, N.Y.), 2019-04, Vol.42 (Supplement_1), p.A203-A204
  • Description: Introduction This study was performed to assess the impact of use of PAP therapy for moderate or severe OSA on hospital-based care and costs in a large southeastern health system. Methods A retrospective cohort study was conducted among patients who had an in-laboratory sleep study with Atrium Health between Jan 1, 2014 and Dec 31, 2016. Patients were eligible if they: were at least 18 years old, were diagnosed with OSA, initiated PAP therapy, had an apnea-hypopnea index ≥ 15/hour and had a central apnea index ≤15/hour. Patients’ daily PAP usage data was obtained from Somnoware, a proprietary cloud-based management platform. Other data were obtained from the Atrium Health’s electronic data warehouse which contains patients’ clinical, billing, and scheduling data. Results The study consisted of 1098 patients, of which 60% (n=665) were on PAP >4 hours/night for ≥70% of the studied nights. After adjusting for significant covariates, association between PAP usage and acute care utilization was still evident in different measures of adherence. Increasing PAP usage was negatively associated with inpatient (IP) and overall acute care visits. For every 1 hour/night increase in PAP usage, there was 8% decrease in IP visits (RR=0.92, 95% CI:0.86-0.98) and 4% decrease in overall visits (RR=0.96, 95% CI:0.92-0.99). Increasing PAP usage was associated with less likelihood of having positive cost from IP (OR=0.93, 95% CI:0.86-1.00) and overall acute care visits (OR=0.94, 95% CI:0.89-1.00). Conclusion Broadly, use of PAP therapy above 4 hours per night over the 18m period was associated with a reduction in overall inpatient visits and costs. There was a linear response to hours of PAP usage to reduction in acute care visits. Using CMS criteria to PAP changed some of the subcategory associations, but generally led to similar conclusions of reduced visits and costs with patients using PAP >4h/70% (a slightly higher bar than averaging more than 4 hours/night). As patients and healthcare systems evaluate methods to reduce medical costs, treating OSA effectively should be considered part of the solution. Support (If Any) NA
  • Publisher: Westchester: Oxford University Press
  • Language: English
  • Identifier: ISSN: 0161-8105
    EISSN: 1550-9109
    DOI: 10.1093/sleep/zsz067.506
  • Source: ProQuest One Psychology
    AUTh Library subscriptions: ProQuest Central
    Alma/SFX Local Collection
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