An alternative model in the provision of CPAP in sleep apnea: a comparative cost analysis

Abstract

Background To conduct a pilot study on an alternative model for the provision of respiratory therapies in sleep apnea-hypopnea syndrome (SAHS) by internalizing the service with the purchase, monitoring and control of continuous positive airway pressure (CPAP) equipment by the hospital. Methods An observational, prospective pilot study of comparative cost analysis by internalizing the service to include all patients up to a budget limit of 5000 euros. The cost of internalizing the service included the acquisition of CPAP equipment and all the necessary accessories in addition to the nursing days necessary to track the patients. Patient satisfaction was assessed by a survey of the hospital service. Results Twenty-one patients with 23,046 patient-days of follow-up were included. The cost of the internalized system was 6825.11 €. The cost of the outsourced system over the same period would have been 22,781.18 €; thus, the direct saving was 15,956.07 €. The cost per device per day of the internalized system was 0.30 € versus the 0.99 € that the outsourced system would have cost during the study period. In the satisfaction survey, 12 (70.6%) patients indicated that they preferred the service of the hospital over that of the external company. No patient preferred the outsourced system. Conclusions The internalization of CPAP service represents significant cost savings from a hospital perspective and an improvement in patients’ perceptions of the quality of service.

Hospitalization Spending for Inpatients Affected by Sleep Disorders: Results from Hunan, China

“…This will impose substantial burden to the affected patients and their families, especially for patients from rural areas: almost all per capita disposable yearly household income for them will be spent on hospital care for sleep disorders. Measures have been proposed to curb the costs for care of patients affected by sleep disorders, including the use of continuous positive airway pressure (27) and telemedicine (28). Rigorous evaluation to demonstrate the cost-effectiveness of these measures could help in developing programs in the future.…”