Tien N Vo1, Allyson M Kats1, Lisa Langsetmo1, Brent C Taylor1,2,3, John T Schousboe4,5, Susan Redline6, Ken M Kunisaki2,7, Katie L Stone8, Kristine E Ensrud1,2,3. 1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN. 2. Department of Medicine, University of Minnesota, Minneapolis, MN. 3. Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN. 4. Park Nicollet Clinic and HealthPartners Institute, Minneapolis, MN. 5. Division of Health Policy and Management, University of Minnesota, Minneapolis, MN. 6. Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. 7. Pulmonary and Sleep, Minneapolis VA Health Care System, Minneapolis, MN. 8. California Pacific Medical Center Research Institute, San Francisco, CA.
Abstract
STUDY OBJECTIVES: To determine the associations of sleep-disordered breathing (SDB) with subsequent healthcare costs and utilization including inpatient and post-acute care facility stays among community-dwelling older men. METHODS: Participants were 1,316 men (mean age 76.1 [SD = 5.7] years) in the Outcomes of Sleep Disorders in Older Men (MrOS sleep) study (from December 2003 to March 2005), who were enrolled in a Medicare Fee-For-Service plan. Primary SDB measures including apnea hypopnea index (AHI) and oxygen desaturation index (ODI) were collected using in-home level 2 polysomnography. Incident healthcare costs and utilization were determined from claims data in the subsequent 3-year period post-MrOS sleep visit. RESULTS: Five hundred and twenty-nine (40.2%) men had at least one hospitalization in the 3-year period. Compared with those without sleep apnea (AHI < 5/hour), men with moderate to severe sleep apnea (AHI ≥ 15/hour) had a higher odds of all-cause hospitalization (odds ratio [OR] adjusted for age and site 1.43, 95% confidence interval [CI]: 1.07-1.90). This association was slightly attenuated after further adjustment for traditional prognostic factors including education, body mass index, comorbid medical conditions, and health status (OR = 1.36; 95% CI: 1.01-1.83). Similar associations were observed for ODI. However, measures of SDB were not related to subsequent healthcare costs (total or outpatient) or odds of post-acute skilled nursing facility stay. CONCLUSIONS: Older men with SDB have an increased risk of hospitalization, not entirely explained by the greater prevalence of comorbid conditions, but not higher subsequent total healthcare costs. These findings indicate a need to evaluate the impact of SDB treatment on subsequent healthcare utilization. Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2019.
STUDY OBJECTIVES: To determine the associations of sleep-disordered breathing (SDB) with subsequent healthcare costs and utilization including inpatient and post-acute care facility stays among community-dwelling older men. METHODS: Participants were 1,316 men (mean age 76.1 [SD = 5.7] years) in the Outcomes of Sleep Disorders in Older Men (MrOS sleep) study (from December 2003 to March 2005), who were enrolled in a Medicare Fee-For-Service plan. Primary SDB measures including apnea hypopnea index (AHI) and oxygen desaturation index (ODI) were collected using in-home level 2 polysomnography. Incident healthcare costs and utilization were determined from claims data in the subsequent 3-year period post-MrOS sleep visit. RESULTS: Five hundred and twenty-nine (40.2%) men had at least one hospitalization in the 3-year period. Compared with those without sleep apnea (AHI < 5/hour), men with moderate to severe sleep apnea (AHI ≥ 15/hour) had a higher odds of all-cause hospitalization (odds ratio [OR] adjusted for age and site 1.43, 95% confidence interval [CI]: 1.07-1.90). This association was slightly attenuated after further adjustment for traditional prognostic factors including education, body mass index, comorbid medical conditions, and health status (OR = 1.36; 95% CI: 1.01-1.83). Similar associations were observed for ODI. However, measures of SDB were not related to subsequent healthcare costs (total or outpatient) or odds of post-acute skilled nursing facility stay. CONCLUSIONS: Older men with SDB have an increased risk of hospitalization, not entirely explained by the greater prevalence of comorbid conditions, but not higher subsequent total healthcare costs. These findings indicate a need to evaluate the impact of SDB treatment on subsequent healthcare utilization. Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2019.
Authors: S Redline; M H Sanders; B K Lind; S F Quan; C Iber; D J Gottlieb; W H Bonekat; D M Rapoport; P L Smith; J P Kiley Journal: Sleep Date: 1998-11-01 Impact factor: 5.849
Authors: E Shahar; C W Whitney; S Redline; E T Lee; A B Newman; F J Nieto; G T O'Connor; L L Boland; J E Schwartz; J M Samet Journal: Am J Respir Crit Care Med Date: 2001-01 Impact factor: 21.405
Authors: Glaucylara Reis Geovanini; Rui Wang; Jia Weng; Russell Tracy; Nancy S Jenny; Ary L Goldberger; Madalena D Costa; Yongmei Liu; Peter Libby; Susan Redline Journal: Int J Cardiol Date: 2018-04-15 Impact factor: 4.039
Authors: John T Schousboe; Allyson M Kats; Katie L Stone; Lisa Langsetmo; Tien N Vo; Terri L Blackwell; Daniel J Buysse; Sonia Ancoli-Israel; Kristine E Ensrud Journal: Sleep Date: 2020-10-13 Impact factor: 5.849