Wickwire Emerson M, Albrecht Jennifer S, Dorsch Jennifer J, Parthasarathy Sairam, Collen Jacob, Capaldi Vincent F, Johnson Abree, Vadlamani Aparna, Scharf Steven M
Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.
Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
J Clin Sleep Med. 2020 May 15;16(5):689-694. doi: 10.5664/jcsm.8326. Epub 2020 Feb 6.
To examine the proportion of Medicare beneficiaries with sleep disorders who were evaluated by board-certified sleep medicine providers (BCSMPs).
Using a random 5% sample of Medicare administrative claims data (2007-2011), BCSMPs were identified by employing a novel cross-matching approach based on National Provider Identifiers available within the Medicare database. Sleep disorders were included based partially on the International Classification of Sleep Disorders, Third Edition (insomnia, sleep-related breathing disorders, hypersomnias, circadian rhythm sleep-wake disorders, parasomnias, and restless legs syndrome), and operationalized as International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. The proportion of beneficiaries with each disorder who were seen by BCSMPs and nonspecialists was computed.
Among older adult Medicare beneficiaries with sleep disorders, the most common sleep disorder was insomnia (n = 65,033), and the least common sleep disorder was narcolepsy (n = 784). Individuals with central sleep apnea (n = 1,561) were most likely to be treated by a BCSMP (63.9% of beneficiaries with central sleep apnea), and individuals diagnosed with insomnia were least likely to be treated by a BCSMP (16.4% of beneficiaries with insomnia). Most BCSMPs treated beneficiaries with obstructive sleep apnea (84.9% of BCSMPs) and insomnia (75.8% of BCSMPs).
BCSMPs are involved in the care of a substantial proportion of Medicare beneficiaries with sleep disorders.
调查由具备睡眠医学专业认证的医疗服务提供者（BCSMPs）评估的患有睡眠障碍的医疗保险受益人的比例。
利用医疗保险管理索赔数据的5%随机样本（2007 - 2011年），通过基于医疗保险数据库中可用的国家提供者识别码采用一种新颖的交叉匹配方法来识别BCSMPs。睡眠障碍部分基于《国际睡眠障碍分类》第三版（失眠、睡眠相关呼吸障碍、发作性睡病、昼夜节律性睡眠 - 觉醒障碍、异态睡眠和不宁腿综合征）纳入，并作为《疾病和有关健康问题的国际统计分类》第九次修订本临床修订版诊断代码进行操作化处理。计算了患有每种疾病的受益人被BCSMPs和非专科医生诊治的比例。
在患有睡眠障碍的老年医疗保险受益人中，最常见的睡眠障碍是失眠（n = 65,033），最不常见的睡眠障碍是发作性睡病（n = 784）。中枢性睡眠呼吸暂停患者（n = 1,561）最有可能由BCSMPs治疗（中枢性睡眠呼吸暂停受益人的63.9%），而被诊断为失眠的患者最不可能由BCSMPs治疗（失眠受益人的16.4%）。大多数BCSMPs治疗阻塞性睡眠呼吸暂停患者（84.9%的BCSMPs）和失眠患者（75.8%的BCSMPs）。
BCSMPs参与了相当一部分患有睡眠障碍的医疗保险受益人的护理。
