Author/Authors :
Alan Stewart, Samuel Department of Community Health and Epidemiology - Faculty of Medicine - Dalhousie University, Halifax, Canada , Penz, Erika Division of Respirology Critical Care and Sleep Medicine - College of Medicine, University of Saskatchewan, Saskatoon, Canada , Fenton, Mark Division of Respirology Critical Care and Sleep Medicine - College of Medicine, University of Saskatchewan, Saskatoon, Canada , Skomro, Robert Division of Respirology Critical Care and Sleep Medicine - College of Medicine, University of Saskatchewan, Saskatoon, Canada
Abstract :
Objective.Obstructive sleep apnea is a common problem, requiring expensive in-lab polysomnography for proper diagnosis.Home
monitoring can provide an alternative to in-lab testing for a subset of OSA patients.The objective of this project was to investigate
the effect of incorporating home testing into anOSAprogramat a large, tertiary sleep disorders centre. Methods.The Sleep Disorders
Centre in Saskatoon, Canada, has been incorporating at-home testing into their diagnostic pathways since 2006. Administrative
data from 2007 to 2013 were extracted (10030 patients) and the flow of patients through the program was followed from diagnosis
to treatment. Costs were estimated using 2014 pricing and were stratified by disease attributes and sensitivity analysis was applied.
Results.The overall costs per patient were $627.40, with $419.20 for at-home testing and $746.20 for in-lab testing.The cost of home
management would rise to $515 if all negative tests were required to be confirmed by an in-lab PSG. Discussion. Our reviewsuggests
that at-home testing can be cost-effective alternative to in-lab testing when applied to the correct population, specifically, those with
a high pretest probability of obstructive sleep apnea and an absence of significant comorbidities.
