Use of vouchers for CPAP therapy initiation - public and private health care could work together.

Abstract

The increasing incidence of sleep apnea has led to an increased workload for healthcare professionals. Continuous positive airway pressure (CPAP) is the gold standard therapy for obstructive sleep apnea. To reduce the CPAP waiting list in public healthcare, we proposed a CPAP voucher for use in private clinics for CPAP initiation. This study evaluated the success rate of CPAP initiation via this voucher. We selected patients from our sleep apnea clinic referred to CPAP initiation aged 18-80 years with no significant physical or psychological comorbidity. Three private clinics (A, B, C) accepted the CPAP voucher. A total of 1922 patients fulfilled CPAP voucher criteria. Of these, we included 1604 patients (38% women). Mean BMI was 32kg/m2, mean age was 55 years, and mean apnea-hypopnea index was 34/h. Data were missing for 113 patients at the 1-year follow-up visit. Of the remaining 1491 patients, 1398 continued CPAP therapy beyond 1 year, indicating a CPAP therapy success rate of 94%. There were no significant differences between clinics in the number of patients staying on CPAP at 1 year after initiation. A CPAP voucher may reduce the CPAP initiation waiting list in public healthcare with a good success rate.