Effect of healthcare benefits on short-term adherence of positive airway pressure therapy.

Abstract

The objective of this study was to assess the impact of healthcare benefits on adherence to positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) patients. Medical records of OSA patients at the Veterans Health Service Medical Center were retrospectively reviewed. OSA patients were assigned to two groups as the date of prescribing PAP: after (=Group A) and before (=Group B) July 1, 2018 when PAP therapy starts to be included in healthcare insurance coverage for OSA patients in South Korea. PAP adherence was compared over a 3-month period between the two groups; subjective improvement after therapy was evaluated using the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index scores. In addition, we evaluated a number of OSA patients who chose to start PAP therapy without healthcare benefit (from July 2018 to December 2018). Each of the 50 patients in the Group A and B exhibited PAP adherence rates of 82% and 26%, respectively (P<.001). Age did not affect PAP adherence in the Group A. The mean apnea-hypopnea index (from 36.7 to 1.34, P<.001) and ESS (from 7.6 to 5.6, P=.004) scores of patients in the Group A had significantly improved within the first three months. Twenty-three (23 out of 334, 6.9%) OSA patients did not have any healthcare insurance, but they medically needed PAP therapy. However, only one of the 23 patients began PAP treatment. Short-term PAP adherence significantly improved after PAP therapy was included in healthcare insurance coverage.