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PEDIATRICS Vol. 110 No. 1 July 2002, pp. 68-72

Health Care Services Utilization in Children With Obstructive Sleep Apnea Syndrome

Haim Reuveni, MD*,{ddagger},§, Tzahit Simon, BA, Asher Tal, MD{ddagger},§, Asher Elhayany, MD*,{ddagger} and Ariel Tarasiuk, PhD{ddagger},||

* Department of Health Policy and Management
{ddagger} Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
§ Department of Pediatrics
|| Physiology and Sleep Disorders Center, Soroka University Medical Center, Beer-Sheva, Israel
Department of Economics and Statistics, Clalit Health Care Services, Beer-Sheva, Israel

Objective. Little is known about the effects of obstructive sleep apnea syndrome (OSAS) on utilization of health care services in children. The present study compares medical service utilization by children with OSAS with that of healthy children.

Methods. A cross-sectional study of 287 consecutively recruited children (1–18 years) with OSAS and no concomitant diseases and a control group matched by age, gender, and geographic location was conducted at the Clalit Health Care Services clinic in the southern region of Israel. Children in the study group underwent nocturnal polysomnography (PSG) studies. The control group (N = 1149) was randomly selected from the Clalit Health Care Services database. PSG was performed for the OSAS patients. Indices of health care utilization 1 year before the PSG study were analyzed.

Results. A 226% increase in health care utilization was noted among children with OSAS. Children up to 5 years of age consumed more health care resources than children over 5 years. Children with OSAS consumed more health care services than the control group at all ages. The leading components of this high cost are utilization of more hospital days, drugs, and visits to the emergency department. The severity of the OSAS correlates directly to total annual costs and independently to age (ß = 0.19).

Conclusions. Children with OSAS are heavy consumers of health care services 1 year before any specific evaluation and treatment for apnea. Early diagnosis and intervention may be cost-effective.

Key Words: children • costs • heath care utilization • obstructive sleep apnea syndrome

Abbreviations: OSAS, obstructive sleep apnea syndrome • T&A, adenotonsillectomy • CHS, Clalit Health Care Services • PSG, polysomnographic • EEG, electroencephalogram • ED, emergency department • RDI, respiratory disturbances index • SEM, standard error of the mean

Received for publication Sep 4, 2001; Accepted Jan 8, 2002.




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