Hospital Use in the Treatment of Sleep Apnea

Abstract

Objectives: Evaluate hospital use for treatment of sleep apnea. Study Design: Retrospective database review. Materials and Methods: The 1998 to 2000 National Inpatient Sample (NIS) was searched for admissions with a diagnosis of sleep apnea. Records were examined for demographics, diagnoses, procedures, and complications. Data were analyzed to identify factors affecting length of stay (LOS) and charges. Results: There were 5,864 (0.03% NIS) admissions for sleep apnea. The sleep apnea group had lower mean age (43.1 vs. 47.2 years), higher percentages of males (71.6% vs. 41.0%) and African Americans (18.7% vs. 13.7%), and higher rates of obesity, hypertension, and anatomic airway diagnoses than the NIS population. Of sleep apnea group adults, 77.1% underwent a mean 2.3 procedures, whereas of those patients under 18 years of age, 60.8% underwent a mean of 1.2 procedures. Tracheotomy and procedures for hypopharyngeal airway compromise were used infrequently. Within the sleep apnea group, there were significant differences in LOS and charges on the basis of age, sex, race, payment method, procedures, and number of secondary diagnoses (all P < .05). Patients over 18 admitted for other diagnoses, but with secondary diagnosis of sleep apnea, had longer LOS (5.38 vs. 4.95 days) and higher charges ($16,562 vs. $13,928) than patients without sleep apnea. Conclusions. Hospital use for sleep apnea remains largely for surgical treatment of the disease. Procedures directed at hypopharyngeal obstruction are seldom used. Multiple factors including patient age, number of secondary diagnoses, and procedures affect LOS and charges. The presence of sleep apnea also increases charges and LOS in patients admitted for other diagnoses.