J Sleep Med.  2020 Dec;17(2):122-127. 10.13078/jsm.200021.

Trends of Clinical Practice for Obstructive Sleep Apnea Following the Change in the National Health Insurance Coverage

• Kim M
• Baek H
• Lee SY

• KMID: 2511095
• DOI: http://doi.org/10.13078/jsm.200021

Abstract

Objectives
We aimed to investigate the recent changes in clinical practice in Korea after the introduction of the national health insurance coverage for polysomnography and positive airway pressure (PAP) treatment for obstructive sleep apnea syndrome (OSAS) in July 2018.
Methods
We assessed the amount, cost, and geographic distribution of healthcare utilization associated with the diagnostic codes of sleep apnea, polysomnography tests, and PAP treatment using the Korea National Health Insurance Database. Furthermore, the specialties of the prescribing physician and the type of health institute were investigated.
Results
The number of patients who used health resources under the diagnostic codes of sleep apnea has increased since 2018. In total, 81,016 polysomnography tests were performed from July 2018 to December 2019, and 58,213 patients underwent PAP treatment from July 2018 to March 2020. The total medical cost associated with sleep apnea was 56,517,061 thousand won in 2019. Auto-titrating PAP accounted for 85.1% of all PAP devices prescribed, and the overall adherence rate for PAP was 69.3%. PAP was prescribed most frequently in private clinics (49.9%) and mostly by physicians of ear-nose-throat (66.6%), neurology (18.7%), and psychiatry (10.3%) specializations. PAP was used more frequently by those living in urban areas than by those living in rural areas.
Conclusions
Recent changes in the national health insurance coverage have resulted in a surge in the healthcare utilization related to OSAS. There was a regional variation in OSAS treatment, suggesting an inequality in the availability of healthcare for OSAS and the need to improve the awareness regarding OSAS.