Unscheduled health care visits in children with obstructive sleep apnea and the impact of positive airway pressure therapy

Abstract

PURPOSE: Untreated OSA in children leads to health complications and unscheduled acute health care visits. We aimed to determine the frequency of unscheduled health care visits and costs in children with OSA and the impact of PAP therapy. METHODS: We linked the sleep database at the Children’s Hospital of Eastern Ontario, in Ottawa, Canada, with provincial health administrative data between April 1, 2009 and March 31, 2013. We compared mean annual unscheduled health care visits in a cohort of children 0 − 7 years old with OSA who were eligible for PAP therapy to matched controls without OSA. We further compared unscheduled visits and costs 12 months after starting PAP in this same cohort. RESULTS: We matched 45 children with untreated OSA with 90 controls. Children with OSA had a higher mean number of emergency department visits (1.18/year vs 0.63/year, p < 0.01) and hospital admissions (0.62/year vs. 0.14/year, p < 0.01) compared to controls. The mean number of emergency department visits (1.13/year vs. 0.86/year, −0.27 mean difference, 95%CI −0.71, 0.17), hospitalizations (0.76/year vs 0.55/year, −0.2 mean difference, 95%CI =-.57, 0.17), and mean annual health care costs did not change significantly after initiation of PAP therapy. CONCLUSIONS: We observed that children with untreated OSA have a higher frequency of unscheduled acute health care visits, but the initiation of PAP did not significantly reduce this.