Bahammam A, Delaive K, Ronald J, Manfreda J, Roos L, Kryger M H
Sleep Disorders Centre, St. Boniface General Hospital Research Centre, Department of Medicine, Winnipeg, Manitoba.
Sleep. 1999 Sep 15;22(6):740-7. doi: 10.1093/sleep/22.6.740.
To document changes in health care utilization (physician claims and hospitalizations) two years after diagnosis and treatment of patients with OSAS.
Prospective observational cohort study.
The study was done in the Canadian Province of Manitoba. OSAS patients were selected from a University-based sleep disorders center. Control subjects were selected from the general population.
There were 344 OSAS patients on whom there was utilization data for the period of the study. They were matched to controls from the general population by gender, age, and geographic location.
The difference in physician claims between the patients and their matched controls two years after diagnosis and treatment ($174+/-32.4 (SE) per year in Canadian dollars) was significantly less than the difference in the year before diagnosis ($260+/-35.7 (SE), p=0.038). Examining the subgroups of patients adhering (PAT) or not adhering (PNAT) to treatment revealed that the changes were only significant in the patients adhering to treatment. Hospital stays for the entire OSAS group decreased from 1.27 days+0.25(SE) per patient per year one year before diagnosis to 0.54+0.13 per patient per year (p=0.01). The changes in the PAT group (1.25+0.28 per patient per year one year before diagnosis to 0.53+0.14 per patient per year (p=0.034) were significant while in the PNAT group they were not.
Adherence to treatment in patients with OSAS results in a significant reduction in physician claims and hospital stays.
记录阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者诊断和治疗两年后的医疗保健利用率(医生诊疗费用和住院情况)变化。
前瞻性观察队列研究。
研究在加拿大曼尼托巴省进行。OSAS患者从一家大学睡眠障碍中心选取。对照对象从普通人群中选取。
有344例OSAS患者在研究期间有利用率数据。他们按性别、年龄和地理位置与普通人群中的对照进行匹配。
患者与其匹配对照在诊断和治疗两年后的医生诊疗费用差异(每年174加元±32.4(标准误))显著小于诊断前一年的差异(260加元±35.7(标准误),p = 0.038)。检查坚持治疗(PAT)或未坚持治疗(PNAT)的患者亚组发现,变化仅在坚持治疗的患者中显著。整个OSAS组的住院天数从诊断前一年的每位患者每年1.27天±0.25(标准误)降至每位患者每年0.54天±0.13天(p = 0.01)。PAT组的变化(诊断前一年每位患者每年1.25天±0.28天降至每位患者每年0.53天±0.14天(p = 0.034))显著,而PNAT组则不显著。
OSAS患者坚持治疗可显著降低医生诊疗费用和住院天数。