The economic impact of obstructive sleep apnea

Tarasiuk, Ariel; Reuveni, Haim

doi:10.1097/mcp.0b013e3283659e1e

Cited by 117 publications

(88 citation statements)

References 62 publications

(85 reference statements)

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“…In non-CMVO populations, unidentified and/or untreated OSA incurs two-fold higher medical expenses, largely associated with cardiovascular disease. 42 To the extent that commercial drivers have been studied, this group appears to be no exception. In a study of commercial drivers undergoing a corporate-driven OSA detection and treatment program, CPAP intervention in 348 drivers with sleep-disordered breathing resulted in a 47.8% reduction in per-member per-month health care spending.…”

Section: Diagnosing and Treating Osa In Commercial Truck Drivers Is Lmentioning

confidence: 99%

Management of Obstructive Sleep Apnea in Commercial Motor Vehicle Operators: Recommendations of the AASM Sleep and Transportation Safety Awareness Task Force

Gurubhagavatula

Sullivan

Meoli

et al. 2017

Journal of Clinical Sleep Medicine

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Section: Diagnosing and Treating Osa In Commercial Truck Drivers Is Lmentioning

confidence: 99%

Management of Obstructive Sleep Apnea in Commercial Motor Vehicle Operators: Recommendations of the AASM Sleep and Transportation Safety Awareness Task Force

Gurubhagavatula

Sullivan

Meoli

et al. 2017

Journal of Clinical Sleep Medicine

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“…31 OSA contributes to a substantial economic burden on society, with potential costs attributed to diagnosis and treatment, diminished quality of life, medical consequences, motor vehicle accidents (estimated to cost $15.9 billion in 2000), and occupational losses. 32 The estimated annual cost of treating the medical sequelae of OSA is $3.4 billion in the United States. 32 Post-rhinoplasty, the burden of managing OSA can be challenging.…”

Section: Osa and Rhinoplastymentioning

confidence: 99%

“…32 The estimated annual cost of treating the medical sequelae of OSA is $3.4 billion in the United States. 32 Post-rhinoplasty, the burden of managing OSA can be challenging. For patients using nasal continuous positive airway pressure (CPAP) devices preoperatively, clinicians must consider the utility of nasal packing, wound care, and the timing to reinstatement of CPAP use.…”

Section: Osa and Rhinoplastymentioning

confidence: 99%

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Ishii

Tollefson

Basura

et al. 2017

Otolaryngol.--head neck surg.

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Objective. Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work.The resultant psychological impact of rhinoplasty can also be significant. Furthermore, the health care burden from psychological pressures of nasal deformities/aesthetic shortcomings, surgical infections, surgical pain, side effects from antibiotics, and nasal packing materials must also be considered for these patients. Prior to this guideline, limited literature existed on standard care considerations for pre-and postsurgical management and for standard surgical practice to ensure optimal outcomes for patients undergoing rhinoplasty. The impetus for this guideline is to utilize current evidence-based medicine practices and data to build unanimity regarding the peri-and postoperative strategies to maximize patient safety and to optimize surgical results for patients.Purpose. The primary purpose of this guideline is to provide evidence-based recommendations for clinicians who either perform rhinoplasty or are involved in the care of a rhinoplasty candidate, as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The target audience is any clinician or individual, in any setting, involved in the management of these patients. The target patient population is all patients aged ≥15 years. The guideline is intended to focus on knowledge gaps, practice variations, and clinical concerns associated with this surgical procedure; it is not intended to be a comprehensive reference for improving nasal form and function after rhinoplasty. Recommendations in this guideline concerning education and counseling to the patient are also intended to include the caregiver if the patient is <18 years of age.Action Statements. The Guideline Development Group made the following recommendations: (1) Clinicians should ask all patients seeking rhinoplasty about their motivations for surgery and their expectations for outcomes, should provide feedback on whether those expectations are a realistic goal of surgery, and should document this discussion in the medical record. (2) Clinicians should assess rhinoplasty candidates for comorbid conditions that could modify or contraindicate surgery, including obstructive sleep apnea, body dysmorphic disorder, bleeding disorders, or chronic use of topical vasoconstrictive intranasal drugs. (3) The surgeon, or the surgeon's designee, should evaluate the rhinoplasty candidate for...

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“…Costeffectiveness analysis (CEA), a technique that provides a framework for assessing value for money spent among alternative management strategies, shows that treatment of OSA with PAP is cost-effective compared to no treatment [22][23][24]. For example, one CEA showed societal incremental costeffectiveness ratio (ICER) of $314 per quality-adjusted life year (QALY) gained which compares very favorably to other large, publically funded health interventions based on a willingness to pay a threshold of $50,000 per QALY [24,25].…”

Section: Introductionmentioning

confidence: 99%

“…OSA patients consume significant healthcare resources, and this results in an annual economic burden estimated to be in the billions of dollars just in the USA alone [21][22][23]. Costeffectiveness analysis (CEA), a technique that provides a framework for assessing value for money spent among alternative management strategies, shows that treatment of OSA with PAP is cost-effective compared to no treatment [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Home- vs. Laboratory-Based Management Of OSA: An Economic Review

Kim

Kapur

2016

Curr Sleep Medicine Rep

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Obstructive sleep apnea (OSA) is a common condition that impairs quality of life and health. Diagnosis and treatment of OSA is cost-effective; however, the economics of various management strategies remain to be defined. Home sleep apnea tests (HSAT) provide an alternative to laboratory based polysomnography (PSG) and are less expensive than PSG on a per test basis; however, when utilized within a framework that has been demonstrated to provide comparable clinical outcomes, home testing pathways incur additional costs to compensate for failed studies and lower diagnostic accuracy. A cost-minimization analysis from a randomized controlled trial showed that the cost advantage of a home management pathway narrowed significantly when these additional costs are considered. Further, when the actual costs of providing HSAT rather than what is reimbursed by insurance were considered, the cost advantage was further attenuated. A comprehensive cost-effectiveness analysis (CEA), favored a lab over a home approach based on modeling that projected that the costs of erroneous diagnosis over a long time span for the home approach outweighed lower test costs. Studies have identified the following factors that influence costeffectiveness of home-based management: cost of untreated OSA, prevalence of OSA, performance characteristics of the selected test, time horizon, and whether backup PSG is used for failed HSAT. More clinical studies are needed to provide the inputs for more robust CEA regarding this issue.

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The economic impact of obstructive sleep apnea

Cited by 117 publications

References 62 publications

Management of Obstructive Sleep Apnea in Commercial Motor Vehicle Operators: Recommendations of the AASM Sleep and Transportation Safety Awareness Task Force

Management of Obstructive Sleep Apnea in Commercial Motor Vehicle Operators: Recommendations of the AASM Sleep and Transportation Safety Awareness Task Force

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Home- vs. Laboratory-Based Management Of OSA: An Economic Review

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