Frequency of provision of CPAP in the inpatient setting: an observational study

Abstract

This rate of provision of CPAP to hospitalized patients, while low at 26%, is much higher than a previous study on this topic that estimated frequency of use of CPAP strictly linking diagnostic codes for OSA and procedural codes for CPAP.

Financial incentive of home continuous positive airway pressure machine use in the inpatient hospital setting

“…In addition, the expense of the CPAP mask is not included in the charge, nor is the cost of provision of multiple masks for those patients who cannot tolerate the initial masks provided by the hospital. In a previous study looking at the use of CPAP for inpatients, 10% of those studied did not use the CPAP provided by the hospital, and the most common reason for this was intolerance . At this institution, the hospital‐provided mask is a full face mask, and intolerance for the full face mask has been attributed not only to its being bulky headgear and causing claustrophobia, but also due to the effects of transmural pressure .…”

“…These are projected to save the US healthcare system tens of thousands of lives and billions of dollars. 19 Similarly, given the role that moderate and severe OSA plays in the acute exacerbation of other medical conditions, 8 the implementation of home CPAP machine use for admitted patients with OSA could play a substantial role in decreasing direct costs as well as other associated healthcare costs.…”

“…Moderate and severe sleep apneas are also associated with numerous medical comorbidities including hypertension, stroke, and diabetes, and therefore have the potential to complicate ambulatory and inpatient treatment for these patients . In light of these findings, OSA has been increasingly highlighted as a significant factor in perioperative and inpatient healthcare.…”

“…In a 2004 study of the National Hospital Discharge Survey, only 5.8% of admitted patients with a history of OSA were prescribed CPAP while inpatients . A second study from 2011 found that CPAP was prescribed to 26% of admitted patients previously diagnosed with OSA . However, neither of these studies reported on the use of home versus hospital‐provided CPAP machines or evaluated the differences in cost between these two options.…”

“…7 Moderate and severe sleep apneas are also associated with numerous medical comorbidities including hypertension, stroke, and diabetes, and therefore have the potential to complicate ambulatory and inpatient treatment for these patients. 8 In light of these findings, OSA has been increasingly highlighted as a significant factor in perioperative and inpatient healthcare. However, despite the recognition that treatment of OSA in hospitalized patients is of particular importance, little is currently known about the use patterns of CPAP therapy for inpatients.…”