Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients
Background and Objective Positive airway pressure (PAP) is considered a standard treatment for obstructive sleep apnea (OSA). Although PAP is effective in resolving upper airway collapse, a major challenge is maximizing adherence. Polysomnography and PAP have been included in Korean National Health...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Sleep Medicine
2020-12-01
|
| Series: | Sleep Medicine Research |
| Subjects: | |
| Online Access: | http://www.sleepmedres.org/upload/pdf/smr-2020-00766.pdf |
| _version_ | 1818639725269876736 |
|---|---|
| author | Ji-Hwan Park Ji-Hun Kang Myeong-Gu Seo Ha-Nee Kwon Sung-Dong Kim Kyu-Sup Cho |
| author_facet | Ji-Hwan Park Ji-Hun Kang Myeong-Gu Seo Ha-Nee Kwon Sung-Dong Kim Kyu-Sup Cho |
| author_sort | Ji-Hwan Park |
| collection | DOAJ |
| description | Background and Objective Positive airway pressure (PAP) is considered a standard treatment for obstructive sleep apnea (OSA). Although PAP is effective in resolving upper airway collapse, a major challenge is maximizing adherence. Polysomnography and PAP have been included in Korean National Health Insurance (NHI) coverage since July 2018. This study was performed to investigate the adherence to PAP therapy according to the device manager after NHI coverage in OSA patients. Methods Between July 2018 and May 2020, a total of 211 patients were prescribed PAP in a single tertiary hospital, and the PAP devices were managed by two companies. Among them, 187 patients constituted the final study population. Assessment of adherence was performed at 3 and 12 months after initiating PAP therapy. Good adherence was defined as using a PAP device for ≥ 4 hours daily and on ≥ 70% of nights. Results Ninety-three patients used the PAP machine obtained from device manager A and 94 patients used the PAP machine obtained from device manager B. During 90 days, the total good adherence rate was 66.8% (n = 125). The good adherence rate for device manager A was 66.7% (62/93) and that for device manager B was 67.0% (63/94), which was not statistically different (p = 0.959). However, the good adherence rate at 1 year after initiating PAP therapy was 38.7% (36/93) for device manager A and 58.5% (55/94) for device manager B, which was statistically significant (p = 0.007). Conclusions The good adherence rate was decreased at 1 year after initiating PAP therapy despite NHI coverage. Furthermore, the device manager may play an important role in increasing the adherence rate in patients with OSA. |
| first_indexed | 2024-12-16T22:59:56Z |
| format | Article |
| id | doaj.art-6db196fe55b84e6f91dd30c7a05045fd |
| institution | Directory Open Access Journal |
| issn | 2093-9175 2233-8853 |
| language | English |
| last_indexed | 2024-12-16T22:59:56Z |
| publishDate | 2020-12-01 |
| publisher | Korean Society of Sleep Medicine |
| record_format | Article |
| series | Sleep Medicine Research |
| spelling | doaj.art-6db196fe55b84e6f91dd30c7a05045fd2022-12-21T22:12:45ZengKorean Society of Sleep MedicineSleep Medicine Research2093-91752233-88532020-12-0111214014410.17241/smr.2020.00766167Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea PatientsJi-Hwan Park0Ji-Hun Kang1Myeong-Gu Seo2Ha-Nee Kwon3Sung-Dong Kim4Kyu-Sup Cho5 Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, KoreaBackground and Objective Positive airway pressure (PAP) is considered a standard treatment for obstructive sleep apnea (OSA). Although PAP is effective in resolving upper airway collapse, a major challenge is maximizing adherence. Polysomnography and PAP have been included in Korean National Health Insurance (NHI) coverage since July 2018. This study was performed to investigate the adherence to PAP therapy according to the device manager after NHI coverage in OSA patients. Methods Between July 2018 and May 2020, a total of 211 patients were prescribed PAP in a single tertiary hospital, and the PAP devices were managed by two companies. Among them, 187 patients constituted the final study population. Assessment of adherence was performed at 3 and 12 months after initiating PAP therapy. Good adherence was defined as using a PAP device for ≥ 4 hours daily and on ≥ 70% of nights. Results Ninety-three patients used the PAP machine obtained from device manager A and 94 patients used the PAP machine obtained from device manager B. During 90 days, the total good adherence rate was 66.8% (n = 125). The good adherence rate for device manager A was 66.7% (62/93) and that for device manager B was 67.0% (63/94), which was not statistically different (p = 0.959). However, the good adherence rate at 1 year after initiating PAP therapy was 38.7% (36/93) for device manager A and 58.5% (55/94) for device manager B, which was statistically significant (p = 0.007). Conclusions The good adherence rate was decreased at 1 year after initiating PAP therapy despite NHI coverage. Furthermore, the device manager may play an important role in increasing the adherence rate in patients with OSA.http://www.sleepmedres.org/upload/pdf/smr-2020-00766.pdfnational health insurance; continuous positive airway pressure; sleep apneaobstructive; patient compliance; health personnel |
| spellingShingle | Ji-Hwan Park Ji-Hun Kang Myeong-Gu Seo Ha-Nee Kwon Sung-Dong Kim Kyu-Sup Cho Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients Sleep Medicine Research national health insurance; continuous positive airway pressure; sleep apnea obstructive; patient compliance; health personnel |
| title | Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients |
| title_full | Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients |
| title_fullStr | Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients |
| title_full_unstemmed | Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients |
| title_short | Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients |
| title_sort | effect of national health insurance coverage on adherence to positive airway pressure therapy in obstructive sleep apnea patients |
| topic | national health insurance; continuous positive airway pressure; sleep apnea obstructive; patient compliance; health personnel |
| url | http://www.sleepmedres.org/upload/pdf/smr-2020-00766.pdf |
| work_keys_str_mv | AT jihwanpark effectofnationalhealthinsurancecoverageonadherencetopositiveairwaypressuretherapyinobstructivesleepapneapatients AT jihunkang effectofnationalhealthinsurancecoverageonadherencetopositiveairwaypressuretherapyinobstructivesleepapneapatients AT myeongguseo effectofnationalhealthinsurancecoverageonadherencetopositiveairwaypressuretherapyinobstructivesleepapneapatients AT haneekwon effectofnationalhealthinsurancecoverageonadherencetopositiveairwaypressuretherapyinobstructivesleepapneapatients AT sungdongkim effectofnationalhealthinsurancecoverageonadherencetopositiveairwaypressuretherapyinobstructivesleepapneapatients AT kyusupcho effectofnationalhealthinsurancecoverageonadherencetopositiveairwaypressuretherapyinobstructivesleepapneapatients |