0779 Describing the OSA Patient Journey from Testing to PAP Treatment. (25th May 2022)

• Record Type: Journal Article
• Authors: Cole, Kathleen; Dexter, R Benjamin; Woodford, Caleb; Sterling, Kimberly
• Is Part Of: Sleep. Volume 45(2022)Supplement 1
• Page Start: A338
• Page End: A339
• Publication Date: 2022-05-25
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsac079.775
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Patients diagnosed with obstructive sleep apnea (OSA) and prescribed positive airway pressure (PAP) therapy for treatment may have differences in experience based on insurance provider, sex, age, or comorbidity status. This retrospective, real-world analysis investigated the factors that impact the patient's OSA journey from initial sleep test to starting PAP therapy. Methods: De-identified US administrative claims data for patients with OSA who had a claim for a sleep test were used for this analysis. Age, sex, and insurance coverage were characterized at the time of the first sleep test. Comorbidity status was evaluated in the year prior to the sleep test by assessing ICD-9/10 codes associated with healthcare encounters. This protocol was submitted to an Institutional Review Board and was determined to be exempt from oversight. Results: In a population of 1, 912, 381 patients, 46.6% were female with mean age of 51.0 years. Insurance coverage was 70.6% commercial, 19.9% Medicaid, and 9.5% Medicare Advantage. Four comorbid cohorts were evaluated including those with hypertension (52.2%), type 2 diabetes (21.7%), COPD (9.7%), and atrial fibrillation (5.9%). Time from sleep test to receiving a PAP device was 7 days longer for females than males (median 49 days vs 42 days). Regardless of type of sleep test (polysomnography (PSG), home sleep test (HST)), those with commercial insurance received a device faster (median 41 days, Medicaid 61 days, Medicare Advantage 50 days). In comparison to those without the respective comorbidity, COPD was the only group with a noticeable increase in time from sleep test to device (median 54 days for those with COPD vs. 43 days for those without). No noticeable differences were observed across age categories. For those that had a titration, it occurred a median of 23 days after PSG or 34 days after HST. Consequently, the two fastest pathways were PSG with split night titration and HST without titration. Conclusion: This retrospective study identified the length of time it takes in a real-world setting for patients to get a PAP device after a sleep test. Depending on demographic factors this time can vary from 1-2 months, delaying the start of OSA treatment. Support (If Any): ResMed