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The Effect of the Transition to Home Monitoring for the Diagnosis of OSAS on Test Availability, Waiting Time, Patients' Satisfaction, and Outcome in a Large Health Provider System

机译:在大型医疗服务提供者系统中,过渡到用于OSAS诊断的家庭监控对测试可用性,等待时间,患者满意度和结果的影响

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摘要

During 2009, the Haifa district of Clalit Health Services (CHS) has switched from in-lab polysomnography (PSG) to home studies for the diagnosis of obstructive sleep apnea (OSA). We assessed the effects of this change on accessibility, waiting time, satisfaction, costs, and CPAP purchase by the patients. Data regarding sleep studies, CPAP purchase, and waiting times were collected retrospectively from the computerized database of CHS. Patients' satisfaction was assessed utilizing a telephone questionnaire introduced to a randomized small sample of 70 patients. Comparisons were made between 2007 and 2008 (in-lab PSGs) and 2010 and 2011 (when most studies were ambulatory). Of about 650000 insured individuals in the Haifa district of CHS, 1471 sleep studies were performed during 2007-2008 compared to 2794 tests during 2010-2011. The average waiting time was 9.9 weeks in 2007-2008 compared to 1.1 weeks in 2010-2011 (P < 0.05). 597 CPAPs were purchased in 2007-2008 compared to 831 in 2010-2011. The overall patients' satisfaction was similar, but discomfort tended to be higher in the in-laboratory group (4.1 vs 2.7 in a scale of 0–10; P = 0.11). Switching to ambulatory diagnosis improved the test accessibility and reduced the waiting times. Patients' satisfaction remained similarly high. The total direct cost of OSA management was reduced.
机译:在2009年期间,Clalit卫生服务(CHS)的海法区已从实验室内多导睡眠图(PSG)转向家庭研究,以诊断阻塞性睡眠呼吸暂停(OSA)。我们评估了这种变化对患者可及性,等待时间,满意度,费用和CPAP购买的影响。从CHS的计算机数据库中回顾性地收集了有关睡眠研究,CPAP购买和等待时间的数据。使用电话调查表对70名患者的随机小样本进行评估,评估患者的满意度。比较了2007年和2008年(实验室内PSG)与2010年和2011年(大多数研究是非卧床的)。 CHS海法区约65万被保险人中,2007-2008年进行了1471次睡眠研究,而2010-2011年进行了2794项测试。 2007-2008年的平均等待时间为9.9周,而2010-2011年的平均等待时间为1.1周(P <0.05)。 2007-2008年购买了597个CPAP,而2010-2011年购买了831个。总体患者满意度相似,但实验室室内组的不适感倾向于更高(0-10级评分分别为4.1 vs 2.7; P = 0.11)。切换到动态诊断可改善测试的可及性并减少等待时间。患者的满意度同样保持较高水平。 OSA管理的总直接成本减少了。

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