Continuous Positive Airway Pressure Adherence and Treatment Cost in Patients With Obstructive Sleep Apnea and Cardiovascular Disease

Autor: Joshua M. Bock, PhD, Keith A. Needham, BS, David A. Gregory, MPA, Mercedes M. Ekono, MPH, Emerson M. Wickwire, PhD, Virend K. Somers, MD, PhD, Amir Lerman, MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 6, Iss 2, Pp 166-175 (2022)
Druh dokumentu: article
ISSN: 2542-4548
DOI: 10.1016/j.mayocpiqo.2022.01.002
Popis: Objective: To determine whether continuous positive airway pressure (CPAP) adherence reduces health care–related costs or use in patients with obstructive sleep apnea (OSA) and comorbid cardiovascular disease (CVD). Patients: A total of 23 million patients with CVD were identified in the Medicare fee-for-service database. Of the 65,198 who completed a sleep study between January 2016 and September 2018, 55,125 were diagnosed as having OSA and 1758 were identified in the 5% Medicare durable medical equipment (DME) database. Methods: Patients with DME claims were categorized as adherent (AD, treatment evidenced ≥91 days after CPAP initiation; n=614) or nonadherent (nAD, n=242) to CPAP therapy. In addition, 9881 individuals with CVD who were not diagnosed as having OSA after sleep testing and without CPAP initiation were included as control patients. Propensity score matching balanced the groups for age, sex, and comorbidities (eg, diabetes mellitus), resulting in 241 participants per cohort. Dependent variables included total episode-of-care, inpatient, outpatient, skilled nursing, home health, and DME costs across 12 months. Results: Total episode-of-care costs of AD participants ($6825) were lower than those of nAD ($11,312; P
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