CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease
| Autor: | Emerson M. Wickwire, M. Doyinsola Bailey, Mukta C. Srivastava, Virend K. Somers, Abree M. Johnson, Liesl M Oldstone, Steven M. Scharf, Jennifer S. Albrecht |
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| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Disease Medicare Cpap adherence Health care Positive airway pressure Humans Medicine Continuous positive airway pressure Aged Inpatients Sleep Apnea Obstructive Health economics Continuous Positive Airway Pressure business.industry Inpatient utilization medicine.disease Scientific Investigations United States respiratory tract diseases Obstructive sleep apnea Neurology Cardiovascular Diseases Emergency medicine Patient Compliance Neurology (clinical) business |
| Zdroj: | J Clin Sleep Med |
| ISSN: | 1550-9397 1550-9389 |
| DOI: | 10.5664/jcsm.9478 |
| Popis: | STUDY OBJECTIVES: To examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. METHODS: Our data source was a random 5% sample of Medicare administrative claims data. All participants (n = 1,921) were of age ≥ 65 years, diagnosed with cardiovascular disease and obstructive sleep apnea, and subsequently began treatment with CPAP between 2009–2013. Based on the number of CPAP machine charges, individuals were categorized as low, partial, or high adherers (ie, < 4, 4–12, and > 12 CPAP charges, respectively). The impact of CPAP adherence status on health care utilization was assessed across multiple points of service, including outpatient encounters, inpatient stays, emergency department visits, and prescription fills over 24 months following CPAP initiation. RESULTS: Significant differences in demographic and comorbid disease characteristics were observed between low adherers (n = 377), partial adherers (n = 236), and high adherers (n = 1,308). After adjusting for covariates and relative to low adherers, high adherers demonstrated reduced inpatient visits (hazard ratio 0.75; 95% confidence interval 0.57, 0.97). CONCLUSIONS: In this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization. CITATION: Wickwire EM, Bailey MD, Somers VK, et al. CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease. J Clin Sleep Med. 2022;18(1):39–45. |
| Databáze: | OpenAIRE |
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