Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Department of Otolaryngology-Head and Neck Surgery, Sainte-Justine Hospital, Montreal, Canada.
Otolaryngol Head Neck Surg. 2021 Sep;165(3):483-489. doi: 10.1177/0194599820986566. Epub 2021 Jan 19.
We previously found that financial concerns negatively affect the quality of life of families of children with persistent obstructive sleep apnea (OSA) after tonsillectomy. The goal is to quantify the financial impact on families of children with persistent OSA and assess contributing factors.
Cross-sectional survey study with comparison group.
Upper airway center at a tertiary pediatric hospital.
Participants included consecutive children with persistent OSA from September to October 2017. Healthy children seen in a general otolaryngology clinic served as controls. Families of both groups completed the Family Impact Questionnaire and the modified Comprehensive Score for Financial Toxicity (COST).
Families of the 50 patients (25 study and 25 control) completed the surveys: the mean age was 6.4 years (95% CI, 5.0-7.8), and 19 (38%) were female. There were no differences in age, sex, race, or insurance status between groups ( > .05). The mean apnea-hypopnea index for the study group was 7.9 events/h (range, 5.5-10.3), and 40% (10/25) had Down syndrome. Positive airway pressure and/or oxygen were used by 72% (18/25). The Comprehensive Score for Financial Toxicity for study patients (21.9; 95% CI, 14.8-26.0) was significantly lower than for controls (30.2; 95% CI, 26.6-30.8; = .003), reflecting elevated financial toxicity. Study families reported greater financial impact on the Family Impact Questionnaire (8.4; 95% CI, 6.1-10.7) versus controls (3.6; 95% CI, 1.8-5.4; = .002); concerns regarding missed days of work and school were common (30.7%).
Families of children with persistent OSA reported a high financial burden related to their children's disease and were more likely to report financial toxicity than families of controls. Concern regarding missed work and school associated with appointments and treatment was a significant factor.
我们之前发现，经济问题会对接受扁桃体切除术的持续性阻塞性睡眠呼吸暂停（OSA）患儿家庭的生活质量产生负面影响。本研究旨在量化持续性 OSA 患儿家庭的经济负担，并评估其影响因素。
具有对照组的横断面调查研究。
三级儿科医院的上气道中心。
参与者包括 2017 年 9 月至 10 月期间持续性 OSA 患儿的连续病例。在普通耳鼻喉科门诊就诊的健康儿童作为对照组。两组患儿家庭均完成家庭影响问卷和改良综合财务毒性评分（COST）。
50 名患儿（25 名研究组和 25 名对照组）的家庭完成了调查：平均年龄为 6.4 岁（95%置信区间，5.0-7.8），19 名（38%）为女性。两组间在年龄、性别、种族和保险状况方面均无差异（>0.05）。研究组的平均呼吸暂停低通气指数为 7.9 次/小时（范围，5.5-10.3），40%（10/25）患儿患有唐氏综合征。72%（18/25）的患儿使用了正压通气和/或吸氧。研究组患儿的综合财务毒性评分（21.9；95%置信区间，14.8-26.0）明显低于对照组（30.2；95%置信区间，26.6-30.8；=0.003），反映出更高的财务毒性。研究组家庭在家庭影响问卷中报告的经济影响更大（8.4；95%置信区间，6.1-10.7），而对照组为（3.6；95%置信区间，1.8-5.4；=0.002）；经常有因预约和治疗而错过工作和上学的担忧（30.7%）。
持续性 OSA 患儿家庭报告了与患儿疾病相关的较高经济负担，且比对照组家庭更有可能报告财务毒性。与预约和治疗相关的工作和上学缺勤的担忧是一个重要因素。
