Changes in Prescription Patterns and Diagnostic Outcomes of Polysomnography After Insurance Coverage: A Multicenter...

Area of Science:

• Sleep Medicine
• Health Policy Analysis
• Diagnostic Access

Background:

• South Korea expanded insurance coverage for polysomnography (PSG) in June 2018 to improve obstructive sleep apnea (OSA) diagnosis.
• This policy aimed to increase diagnostic accessibility for OSA patients.

Purpose of the Study:

• To investigate the impact of expanded insurance coverage on PSG utilization and diagnostic outcomes for OSA.
• To analyze changes in patient demographics and apnea-hypopnea index (AHI) distributions post-policy implementation.

Main Methods:

• A multicenter retrospective study analyzed data from 17 tertiary hospitals in South Korea.
• Included patients (≥20 years) suspected of OSA from 2015-2023, comparing pre-coverage (2015-2017) and post-coverage (2019-2023) periods.
• Compared demographics, PSG rates, and AHI distributions between the two periods.

Main Results:

• PSG utilization increased significantly from 51.3% to 74.4% (p<0.001).
• The proportion of female patients and mean age increased, indicating broader access.
• Average AHI rose, with a significant increase in severe OSA diagnoses (AHI ≥30) and a decrease in normal AHI cases (p<0.001).

Conclusions:

• Expanded insurance coverage improved PSG accessibility, especially for older adults, women, and high-risk individuals.
• The shift towards more severe OSA diagnoses suggests better detection of untreated cases.
• Findings support inclusive health policies while highlighting the need for appropriate patient selection for OSA diagnosis.