Relationship between sleep apnea and hospital readmission in rural and urban populations.

Abstract

The aims of this study were to evaluate geographic differences in obstructive sleep apnea (OSA) prevalence, to determine if readmissions were more likely among rural patients with OSA than others, and to model predictors, including diagnosed OSA, of 30, 60, and 90-day acute-care readmissions. This cohort study employed a secondary analysis of data extracted from the electronic health record shared by all hospitals in a north Texas healthcare system. The sample consisted of records associated with 472,503 adult patients admitted to any of the study system's acute-care facilities from 2016 through 2019. Measurements consisted of case-level health information, including admissions, demographic variables, payors, diagnoses, screens, and physician orders. OSA was significantly related to hospital readmission when considered in isolation but did not significantly predict readmission when modeled with plausible covariates. Screening rates for OSA did not vary by geography. Differences in rural/urban-suburban OSA prevalence were not statistically significant. Findings contrast with previous suggestions that OSA plays an independent role in hospital readmissions or that rural resident may be disadvantaged regarding services that support the OSA diagnosis. Prevalence and screening rates were almost identical in urban and rural populations.