The Impact of National Health Insurance Coverage on Compliance With Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea

Choi, Woori; Bae, Mi Rye; Chung, Yoo‐Sam

doi:10.21053/ceo.2020.02362

Cited by 10 publications

(7 citation statements)

References 30 publications

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“…Previous observational studies have suggested that the long-term maintenance of PAP therapy is influenced by socioeconomic factors and the healthcare system [ 22 ]. Findings from recent Korean observational studies suggest improved long-term compliance with PAP therapy up to 9 months post-implementation of the NHI [ 23 ]. Third, as we only focused on patients undergoing PSG, we may have underestimated the overall prevalence of sleep disorders owing to cases in which patients declined evaluation.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Polysomnographic Characteristics of Adult Patients with Suspected Obstructive Sleep Apnea from Different Sleep Clinics at a Single Tertiary Center

Lee,

Lee

2024

Neurol Ther

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Introduction The characteristics of patients across different sleep clinics may vary because they selectively visit specific specialists on the basis of their primary symptoms. This study aimed to compare the clinical and polysomnography (PSG) features of patients with suspected obstructive sleep apnea (OSA) at three sleep specialty clinics (otolaryngology [ENT], neurology [NR], and psychiatry [PSY]). Methods We retrospectively analyzed the medical records and PSG reports of adult patients who underwent full-night PSG between January 2022 and June 2023 at a tertiary medical center. The demographic, questionnaire, and PSG variables were compared. Results Of the 407 patients, 83.0% exhibited sleep-disordered breathing (apnea–hypopnea index ≥ 5) with varying severity among the specialty pathways. Patients in the ENT group ( n = 231) were the youngest and had the shortest sleep latency and most severe OSA markers with the highest positive airway pressure (PAP) acceptance, while those in the NR group ( n = 79) had similar OSA-related PSG parameters to those in the ENT group but were older and had more OSA-related comorbidities, although their PAP acceptance was relatively low. The PSY group ( n = 97) included a significant proportion of patients with normal or mild OSA, a female majority, high levels of depression, and subjective sleep distress. Conclusion Our results highlight the multidisciplinary aspects of sleep medicine and diverse patients, and specialist needs for diagnosing sleep disorders and PAP acceptance. Exploring the potential differences in prognosis and treatment responses across various sleep specialty clinics would facilitate the development of personalized strategies.

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Section: Discussionmentioning

confidence: 99%

Clinical and Polysomnographic Characteristics of Adult Patients with Suspected Obstructive Sleep Apnea from Different Sleep Clinics at a Single Tertiary Center

Lee,

Lee

2024

Neurol Ther

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“… 10 30 Portable PSG based on peripheral arterial tonometry was validated, and respiratory indexes of portable PSG were well correlated with those of level 1 PSG. 20 31 PSG is reimbursed by the National Health Insurance for the general population, 32 but there are no standard for the PSG test in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea Is Associated With Late-Onset Preeclampsia in Overweight Pregnant Women in Korea

et al. 2023

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Background Obstructive sleep apnea (OSA) is closely related to maternal obesity in pregnant women, and the association increases with later pregnancy. Obesity and OSA are risk factors of pregnancy-related complications, including gestational hypertension, gestational diabetes mellitus (GDM), and fetal morbidities. We aimed to determine the prevalence of OSA and to assess the impact of OSA on pregnancy-related disorders in overweight pregnant women. Methods Eligible participants who were overweight [body mass index (BMI) ≥ 23 kg/m 2 ] in gestational age 30 weeks or more, assessed OSA using a portable polysomnography at home. Clinical data were collected from pregnant women and their babies. Results The average age of 51 participants was 34.5 years (27–44 years). The number of primipara was 25 (49%) and that of multipara was 26 (51%). Eight cases of GDM (15.7%) and five cases of preeclampsia (9.8%) were reported, and six patients (11.8%) experienced preterm delivery. In results of polysomnography, 14 patients (27.5%) were diagnosed as OSA. Apnea-hypopnea index moderately correlated with BMI ( r = 0.515, P < 0.001). The BMI ( P < 0.005) and preeclampsia rate ( P < 0.017) were higher in the OSA group compared to the control group. Odds ratios (ORs) adjusting age, BMI, parity, and abortion history were calculated. The presence of OSA increased OR of preeclampsia (OR, 13.1; 95% confidence interval, 1.1–171.3). The majority of preeclampsia patients (4/5, 80%) underwent preterm delivery. Conclusion OSA is an important risk factor for preeclampsia, resulting in preterm delivery. For overweight pregnant women, an OSA evaluation should be mandatory.

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“…As a result, patient compliance, adherence, and use of PAP therapy increased. 8,9) Since July 2018, the Korean National Health Insurance (NHI) has been covering PAP therapy in patients with moderate-to-severe OSA (apnea hypopnea index [AHI] ≥15) and some complicated patients (lowest SpO2 <85% or lowest SpO2 ≥85% with insomnia, daytime sleepiness, cognitive disorder, mood disorder, hypertension, history of CVD or history of cerebrovascular disease) in mild OSA (5≤AHI<15). However, the salary standard for the use of PAP therapy in the mild OSA group has been strengthened since December 2020.…”

Section: Introductionmentioning

confidence: 99%

Changes in Patients Who Receive Coverage for Positive Airway Pressure Therapy According to Alterations in National Health Insurance Benefit Standards for Mild Obstructive Sleep Apnea

Yoo¹,

Kim²,

Park³

et al. 2023

Korean J Otorhinolaryngol-Head Neck Surg

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Background and ObjectivesThe aim of this study was to identify the frequency of indicators of National Health Insurance (NHI) coverage for positive airway pressure (PAP) therapy and to investigate the changes in patients receiving coverage for PAP therapy after the alterations were made in the insurance benefit standards for mild obstructive sleep apnea (OSA). Subjects and MethodWe divided the mild OSA patients into two groups according to altered categorization in insurance benefit standards (Mild1: 5≤AHI<10; Mild2: 10≤AHI<15). Eight indicators related to the NHI coverage were identified: four symptoms, three complications, and the minimal blood oxygen saturation during polysomnography (min SpO2) of ≤85% during polysomnography. We also investigated the change in the number of patients receiving insurance benefits under the altered insurance benefit standards. Results Of the 233 OSA patients, 66, 57, and 110 patients were diagnosed as mild, moderate and severe OSA, respectively. For all of them, the most common indicator related to NHI coverage for PAP therapy was the minimum SpO2 of less than 85% during polysomnography, and the second most common indicator was daytime sleepiness. In the mild OSA group, however, daytime sleepiness was found to be the most common indicator, found in 46 (70%) patients, followed by 38 (58%) patients with min SpO2 of less than 85%. In this group, 59 (89.4%) would have been benefited before the change in the insurance benefit standards whereas 51 patients (77.3%) would now be benefited under the changed insurance benefit standards. Conclusion Daytime sleepiness was the most commonly observed indicator in the mild OSA patients. The number of patients receiving insurance benefits for PAP therapy significantly decreased after the change was made in the NHI benefit standards for mild OSA .

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The Impact of National Health Insurance Coverage on Compliance With Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea

Cited by 10 publications

References 30 publications

Clinical and Polysomnographic Characteristics of Adult Patients with Suspected Obstructive Sleep Apnea from Different Sleep Clinics at a Single Tertiary Center

Clinical and Polysomnographic Characteristics of Adult Patients with Suspected Obstructive Sleep Apnea from Different Sleep Clinics at a Single Tertiary Center

Obstructive Sleep Apnea Is Associated With Late-Onset Preeclampsia in Overweight Pregnant Women in Korea

Changes in Patients Who Receive Coverage for Positive Airway Pressure Therapy According to Alterations in National Health Insurance Benefit Standards for Mild Obstructive Sleep Apnea

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