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Health care services utilization in children with obstructive sleep apnea syndrome
Haim Reuveni1, Tzahit Simon, Asher Tal
1Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Children with obstructive sleep apnea syndrome (OSAS) use significantly more health care services, including hospital days and emergency visits. Early diagnosis and treatment of pediatric OSAS may reduce these high healthcare costs.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Health Services Research
Background:
- Obstructive sleep apnea syndrome (OSAS) in children is not well understood regarding its impact on healthcare utilization.
- This study aims to compare healthcare service use in children diagnosed with OSAS versus healthy children.
Purpose of the Study:
- To quantify and compare healthcare service utilization in children with OSAS.
- To identify factors influencing healthcare costs associated with pediatric OSAS.
Main Methods:
- A cross-sectional study involving 287 children with OSAS and a control group of 1149 children.
- Nocturnal polysomnography (PSG) was used to diagnose OSAS.
- Healthcare utilization data from the year prior to PSG were analyzed.
Main Results:
- Children with OSAS exhibited a 226% increase in healthcare utilization.
- Increased utilization included more hospital days, medication use, and emergency department visits.
- OSAS severity correlated with higher annual healthcare costs.
Conclusions:
- Children with OSAS are high consumers of healthcare services even before diagnosis and treatment.
- Early detection and intervention for pediatric OSAS could be a cost-effective strategy.
Objective:
Little is known about the effects of obstructive sleep apnea syndrome (OSAS) on utilization of health care services in children. The present study compares medical service utilization by children with OSAS with that of healthy children.
Methods:
A cross-sectional study of 287 consecutively recruited children (1-18 years) with OSAS and no concomitant diseases and a control group matched by age, gender, and geographic location was conducted at the Clalit Health Care Services clinic in the southern region of Israel. Children in the study group underwent nocturnal polysomnography (PSG) studies. The control group (N = 1149) was randomly selected from the Clalit Health Care Services database. PSG was performed for the OSAS patients. Indices of health care utilization 1 year before the PSG study were analyzed.
Results:
A 226% increase in health care utilization was noted among children with OSAS. Children up to 5 years of age consumed more health care resources than children over 5 years. Children with OSAS consumed more health care services than the control group at all ages. The leading components of this high cost are utilization of more hospital days, drugs, and visits to the emergency department. The severity of the OSAS correlates directly to total annual costs and independently to age (beta = 0.19).
Conclusions:
Children with OSAS are heavy consumers of health care services 1 year before any specific evaluation and treatment for apnea. Early diagnosis and intervention may be cost-effective.