TY - JOUR
T1 - Determinants affecting health-care utilization in obstructive sleep apnea syndrome patients
AU - Tarasiuk, Ariel
AU - Greenberg-Dotan, Sari
AU - Brin, Yaron S.
AU - Simon, Tzahit
AU - Tal, Asher
AU - Reuveni, Haim
PY - 2005/9
Y1 - 2005/9
N2 - Study objective: To investigate determinants of health-care utilization in patients with obstructive sleep apnea syndrome (OSAS). Design: Case-control prospective study with OSAS patients and a control group. We compared 218 patients with OSAS to those of age-, gender-, geographically-, and family physician-matched control subjects from the general population, matched 1:1 (χ2 = 0.999). Participants: All participants were members of Clalit Health Care Services, a health maintenance organization in the southern region of Israel. All OSAS patients underwent nocturnal polysomnography studies. Indexes of health-care utilization 2 years prior to the polysomnography were analyzed. Measurements and results: Health-care utilization was 1.7-fold higher (p < 0.001) in the OSAS patients due to more hospitalization days (p < 0.001), consultations (p < 0.001), and cost for drugs (p < 0.05), particularly those for the cardiovascular system. In comparison to men, women consumed significantly more health-care resources (p < 0.001). OSAS patients ≤ 65 of age years consumed 2.2-fold more health-care resources than control subjects (p < 0.001). Polysomnography findings and OSAS severity and body mass index (BMI) did not predict health-care utilization, using muMvariate logistic regression analysis. Age > 65 (odds ratio [OR], 2.2; p < 0.04) and female gender (OR, 2.0; p < 0.05) were the leading elements predicting the most costly OSAS patients. Arbitrarily dividing the OSAS group by cost of health-care utilization, the upper 25% (n = 55) of patients who were the "most costly" consumed sevenfold more health-care resources than the lower 75% of the patients. This was due to higher comorbidity, ie, 10 to 30% more hypertension, ischemic heart disease, diabetes mellitus, and pulmonary disease. Conclusions: OSAS patients are heavy users of health-care resources. Age > 65 years and female gender were the leading elements predicting the most costly OSAS patients, and not necessarily patients with a high BMI and classic OBAS severity indexes.
AB - Study objective: To investigate determinants of health-care utilization in patients with obstructive sleep apnea syndrome (OSAS). Design: Case-control prospective study with OSAS patients and a control group. We compared 218 patients with OSAS to those of age-, gender-, geographically-, and family physician-matched control subjects from the general population, matched 1:1 (χ2 = 0.999). Participants: All participants were members of Clalit Health Care Services, a health maintenance organization in the southern region of Israel. All OSAS patients underwent nocturnal polysomnography studies. Indexes of health-care utilization 2 years prior to the polysomnography were analyzed. Measurements and results: Health-care utilization was 1.7-fold higher (p < 0.001) in the OSAS patients due to more hospitalization days (p < 0.001), consultations (p < 0.001), and cost for drugs (p < 0.05), particularly those for the cardiovascular system. In comparison to men, women consumed significantly more health-care resources (p < 0.001). OSAS patients ≤ 65 of age years consumed 2.2-fold more health-care resources than control subjects (p < 0.001). Polysomnography findings and OSAS severity and body mass index (BMI) did not predict health-care utilization, using muMvariate logistic regression analysis. Age > 65 (odds ratio [OR], 2.2; p < 0.04) and female gender (OR, 2.0; p < 0.05) were the leading elements predicting the most costly OSAS patients. Arbitrarily dividing the OSAS group by cost of health-care utilization, the upper 25% (n = 55) of patients who were the "most costly" consumed sevenfold more health-care resources than the lower 75% of the patients. This was due to higher comorbidity, ie, 10 to 30% more hypertension, ischemic heart disease, diabetes mellitus, and pulmonary disease. Conclusions: OSAS patients are heavy users of health-care resources. Age > 65 years and female gender were the leading elements predicting the most costly OSAS patients, and not necessarily patients with a high BMI and classic OBAS severity indexes.
KW - Age
KW - Costs
KW - Gender
KW - Health-care utilization
KW - Obstructive sleep apnea syndrome
UR - http://www.scopus.com/inward/record.url?scp=24944444122&partnerID=8YFLogxK
U2 - 10.1378/chest.128.3.1310
DO - 10.1378/chest.128.3.1310
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C2 - 16162723
AN - SCOPUS:24944444122
SN - 0012-3692
VL - 128
SP - 1310
EP - 1314
JO - Chest
JF - Chest
IS - 3
ER -
