Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients
Background: Obstructive sleep apnea (OSA) is an important cause of morbidity in the elderly population. Limited data are available regarding the healthcare utilization and predisposing conditions related to OSA in the elderly. Our aim was to evaluate the healthcare utilization and the conditions ass...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Annals of Thoracic Medicine |
| Subjects: | |
| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2014;volume=9;issue=2;spage=92;epage=98;aulast=Diaz |
| _version_ | 1811256272129884160 |
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| author | Karla Diaz Paola Faverio Angela Hospenthal Marcos I Restrepo Megan E Amuan Mary Jo V Pugh |
| author_facet | Karla Diaz Paola Faverio Angela Hospenthal Marcos I Restrepo Megan E Amuan Mary Jo V Pugh |
| author_sort | Karla Diaz |
| collection | DOAJ |
| description | Background: Obstructive sleep apnea (OSA) is an important cause of morbidity in the elderly population. Limited data are available regarding the healthcare utilization and predisposing conditions related to OSA in the elderly. Our aim was to evaluate the healthcare utilization and the conditions associated with new and chronic diagnosis of OSA in a large cohort of elderly patients in the Veterans Health Administration (VHA).
Materials and Methods: This retrospective cohort study used inpatient and outpatient VHA data to identify the individuals diagnosed with OSA using ICD-9 codes during the fiscal years 2003-2005. Primary outcomes were emergency department (ED) visits and hospitalizations. Multivariable logistic regression analysis was performed to identify the demographic and clinical characteristics associated with new and chronic diagnosis of OSA.
Results: Of 1,867,876 elderly veterans having 2 years of care, 82,178 (4.4%) were diagnosed with OSA. Individuals with OSA were younger and more likely to have chronic diseases than those without OSA. Individuals with chronic OSA were more likely to have diagnoses of congestive heart failure (CHF), pulmonary circulation disorders, COPD, and obesity and less likely to have diagnoses of hypertension, osteoarthritis, and stroke than individuals with newly diagnosed OSA. The proportion of patients with new OSA diagnosis who required at least one ED visit was higher than the proportion of chronic OSA and no OSA patients (37%, 32%, and 15%, respectively; P-value <0.05). The proportion of new OSA patients who required at least one hospitalization was also higher than the proportion of chronic OSA and no OSA patients (24%, 17%, and 7%, respectively; P-value <0.05).
Conclusion: Patients with OSA had a higher incidence of healthcare utilization compared to patients without OSA. New OSA patients had a higher rate of healthcare utilization in the year of diagnosis compared to chronic patients and patients without OSA. Early OSA recognition may reduce healthcare utilization in these patients. |
| first_indexed | 2024-04-12T17:37:35Z |
| format | Article |
| id | doaj.art-68bc5fea564043e881443383d8453b05 |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-04-12T17:37:35Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-68bc5fea564043e881443383d8453b052022-12-22T03:22:54ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572014-01-0192929810.4103/1817-1737.128854Obstructive sleep apnea is associated with higher healthcare utilization in elderly patientsKarla DiazPaola FaverioAngela HospenthalMarcos I RestrepoMegan E AmuanMary Jo V PughBackground: Obstructive sleep apnea (OSA) is an important cause of morbidity in the elderly population. Limited data are available regarding the healthcare utilization and predisposing conditions related to OSA in the elderly. Our aim was to evaluate the healthcare utilization and the conditions associated with new and chronic diagnosis of OSA in a large cohort of elderly patients in the Veterans Health Administration (VHA). Materials and Methods: This retrospective cohort study used inpatient and outpatient VHA data to identify the individuals diagnosed with OSA using ICD-9 codes during the fiscal years 2003-2005. Primary outcomes were emergency department (ED) visits and hospitalizations. Multivariable logistic regression analysis was performed to identify the demographic and clinical characteristics associated with new and chronic diagnosis of OSA. Results: Of 1,867,876 elderly veterans having 2 years of care, 82,178 (4.4%) were diagnosed with OSA. Individuals with OSA were younger and more likely to have chronic diseases than those without OSA. Individuals with chronic OSA were more likely to have diagnoses of congestive heart failure (CHF), pulmonary circulation disorders, COPD, and obesity and less likely to have diagnoses of hypertension, osteoarthritis, and stroke than individuals with newly diagnosed OSA. The proportion of patients with new OSA diagnosis who required at least one ED visit was higher than the proportion of chronic OSA and no OSA patients (37%, 32%, and 15%, respectively; P-value <0.05). The proportion of new OSA patients who required at least one hospitalization was also higher than the proportion of chronic OSA and no OSA patients (24%, 17%, and 7%, respectively; P-value <0.05). Conclusion: Patients with OSA had a higher incidence of healthcare utilization compared to patients without OSA. New OSA patients had a higher rate of healthcare utilization in the year of diagnosis compared to chronic patients and patients without OSA. Early OSA recognition may reduce healthcare utilization in these patients.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2014;volume=9;issue=2;spage=92;epage=98;aulast=DiazElderlyemergency department visithealthcare utilizationhospitalizationobstructive sleep apnea |
| spellingShingle | Karla Diaz Paola Faverio Angela Hospenthal Marcos I Restrepo Megan E Amuan Mary Jo V Pugh Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients Annals of Thoracic Medicine Elderly emergency department visit healthcare utilization hospitalization obstructive sleep apnea |
| title | Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients |
| title_full | Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients |
| title_fullStr | Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients |
| title_full_unstemmed | Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients |
| title_short | Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients |
| title_sort | obstructive sleep apnea is associated with higher healthcare utilization in elderly patients |
| topic | Elderly emergency department visit healthcare utilization hospitalization obstructive sleep apnea |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2014;volume=9;issue=2;spage=92;epage=98;aulast=Diaz |
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