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Utilization of surgical treatment for sleep apnea: A study of health disparities.
Ruthberg, Jeremy; Summerville, Lesley; Cai, Yida; Boas, Samuel; Otteson, Todd; Kumar, Anand.
Afiliación
  • Ruthberg J; Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.
  • Summerville L; Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA.
  • Cai Y; Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.
  • Boas S; Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.
  • Otteson T; Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA.
  • Kumar A; Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America. Electronic address: Anand.kumar@uhhospitals.org.
Am J Otolaryngol ; 41(6): 102670, 2020.
Article en En | MEDLINE | ID: mdl-32877799
OBJECTIVE: Barriers to surgical treatment for sleep apnea remain understudied. In this study, we sought to evaluate whether specific demographic and socioeconomic characteristics are associated with whether or not patients receive surgery for sleep apnea management. METHODS: The National Inpatient Sample (NIS) database was analyzed for 2007-2014. Patients aged 18 or older with primary or secondary diagnoses of sleep apnea were selected. Patients were sub-categorized by whether they received related soft-tissue removal or skeletal modifying procedures. Age, race, gender, region, insurance, comorbidities, procedure type, and procedure setting were analyzed between surgical and nonsurgical groups. RESULTS: A total of 449,705 patients with a primary or secondary diagnosis of sleep apnea were identified, with 27,841 (5.8%) receiving surgical intervention. Compared with the non-surgical group, patients in the surgical cohort were more likely to be younger, male (74.4% vs. 59.0%), Hispanic (10.2% vs. 6.2%), Asian (3.6% vs. 1.0%) (p < 0.001), and have less clinical comorbidities. Those receiving surgery were more likely to be in the highest income bracket (36.1% versus 25.1%) and utilize private insurance (76.3% vs. 50.8%). Soft-tissue surgeries comprised 88.5% of total procedures while skeletal modifying procedures constituted 11.5% (p < 0.001). CONCLUSIONS: This study identified multiple demographic, socioeconomic, and clinical discrepancies in the utilization of surgical versus nonsurgical management of sleep apnea in the United States. Future studies should examine the causes for these health disparities in the ultimate effort to provide more equitable healthcare in the United States.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndromes de la Apnea del Sueño / Factores Socioeconómicos / Procedimientos Quirúrgicos Otorrinolaringológicos / Etnicidad / Aceptación de la Atención de Salud / Disparidades en Atención de Salud Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude Límite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Otolaryngol Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndromes de la Apnea del Sueño / Factores Socioeconómicos / Procedimientos Quirúrgicos Otorrinolaringológicos / Etnicidad / Aceptación de la Atención de Salud / Disparidades en Atención de Salud Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude Límite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Otolaryngol Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos