Banno Katsuhisa, Manfreda Jure, Walld Randy, Delaive Kenneth, Kryger Meir H
Sleep Disorders Center, St. Boniface General Hospital, Section of Respiratory Diseases, Winnipeg, Manitoba, Canada.
Sleep. 2006 Oct;29(10):1307-11. doi: 10.1093/sleep/29.10.1307.
SUBJECTIVE OBJECTIVES: To document healthcare utilization 2 years after diagnosis in women with obstructive sleep apnea syndrome (OSAS).
Retrospective observational cohort study.
Tertiary university-based medical center.
Four hundred and fourteen women with OSAS were matched with 1404 women from the general population who served as controls.
Patients were treated with continuous positive airway pressure (CPAP) or were recommended weight loss alone.
There were 231 treatment compliant (TC) patients, 91 patients not using CPAP (NCU), and 92 patients who were only recommended weight loss (WL). In the entire group, there was increase in fees of $123.43+/-$25.01 in the 2 years before diagnosis and a reduction of fees of $37.96+/-$21.35 in the 2 years after diagnosis (p < .0001). Physician claims increased in the 2 years before diagnosis by $111.22+/-31.35 in TC and by $152.77+/-59.55 in the NCU groups and then decreased in TC by $20.96+/-$26.60 (p < .01) and NCU by $72.20 +/-45.91 in the 2 years after diagnosis (p < .01). The fees in WL group did not change significantly. The number of clinic visits of the entire group increased in the 2 years before diagnosis by 2.32+/-0.43 and decreased over the next 2 years by 1.48+/-0.42 visits (p < .0001). There was an increase of clinic visits in the 3 subgroups in the 2 years before diagnosis (2.30+/-0.57 in TC, 2.55+/-0.99 in NCU, and 2.18+/-0.82 in WL groups) followed by a reduction of clinic visits over the next 2 years (1.56+/-0.55 fewer visits in TC [p < .0001], 1.70+/-0.90 in NCU [p < .01], and 1.04+/-0.90 in the WL group [p < .05] ).
Healthcare utilization in women with OSAS increased in the years before sleep-clinic evaluation and then decreased in the following 2 years.
主观目标：记录阻塞性睡眠呼吸暂停综合征（OSAS）女性患者确诊后2年的医疗保健利用情况。
回顾性观察队列研究。
基于大学的三级医疗中心。
414例OSAS女性患者与1404例来自普通人群的女性作为对照进行匹配。
患者接受持续气道正压通气（CPAP）治疗或仅被建议减肥。
有231例治疗依从（TC）患者，91例未使用CPAP（NCU）患者，92例仅被建议减肥（WL）患者。在整个研究组中，确诊前2年费用增加了123.43美元±25.01美元，确诊后2年费用减少了37.96美元±21.35美元（p <.0001）。医师索赔在确诊前2年中，TC组增加了111.22美元±31.35美元，NCU组增加了152.77美元±59.55美元，然后在确诊后2年中，TC组减少了20.96美元±26.60美元（p <.01），NCU组减少了72.20美元±45.91美元（p <.01）。WL组的费用没有显著变化。整个研究组的门诊就诊次数在确诊前2年增加了2.32次±0.43次，在接下来的2年中减少了1.48次±0.42次（p <.0001）。在确诊前2年中，3个亚组的门诊就诊次数均增加（TC组为2.30次±0.57次，NCU组为2.55次±0.99次，WL组为2.18次±0.82次），随后在接下来的2年中门诊就诊次数减少（TC组减少1.56次±0.55次[p <.0001]，NCU组减少1.70次±0.90次[p <.01]，WL组减少1.04次±0.90次[p <.05]）。
OSAS女性患者在睡眠诊所评估前几年的医疗保健利用率增加，随后在接下来的2年中下降。
