Effects on Health Care Utilization of Positive Airway Pressure on Veterans With Obstructive Sleep Apnea Syndrome

Abstract

PURPOSE:Effective treatment with Continuous Positive Airway Pressure (CPAP) for Obstructive Sleep Apnea Syndrome (OSAS), in pilot studies, has been associated with a decrease in utilization of health care resources and costs. However, this benefit has not been studied in a veteran's population. We want to evaluate changes in health care utilization in veterans diagnosed with OSAS and treated with CPAP.METHODS: This is a retrospective review of 122 patients diagnosed with OSAS using a fullnight polysomnogram at the Memphis VAMC. Data obtained from Computerized Patient Record System (CPRS) included: demographics, number of visits to primary care physician (PCP), emergency room (ER), hospital admissions, and number of sub-specialty consults, OSAS severity, and compliance with CPAP. The observation period for the events was one-year, preand-post, CPAP treatment. Paired Student t test was used to compare variables a p ≤; 0.05 was considered significant. RESULTS:Between January 1, 2006 and December 31, 2007, 180 medical records were reviewed. Due to incomplete data in some, only 122 were included in the final analysis. The mean age (yrs) was 57 ± 10; 52% were Caucasian, 42% were African-Americans, and 6% others. Most patients (84%) were smokers. The five most common comorbidities were: Hypertension (68%), Dyslipidemia (50%), Muscle-skeletal problems (40%), Diabetes Mellitus (36%), and Depression (29%). Mean ± SD for BMI was 34.8 ± 7.2; for Epworth-Score was 12 ± 7; and for Apnea Hypopnea Index (AHI) was 32 ± 31 events per hour.CONCLUSION: CPAP therapy for OSAS may decrease the use of health care resources such as primary care physician and emergency department visits in a population of veterans. CLINICAL IMPLICATIONS:If we are able to achieve effective CPAP therapy for OSAS we could potentially decrease the number of visits to the emergency room and/or primary care physician which could have a significant impact on health care costs.