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KMID : 0390220220330030123
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2022 Volume.33 No. 3 p.123 ~ p.129
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Adherence Rate of Positive Airway Pressure after Korean National Health Insurance Coverage
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Choi Seong-Wook
Park Da-Hee
Kim Hyun-Woo
Cho Jae-Wook
Cho Kyu-Sup
Mun Sue-Jean
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Abstract
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Background and Objectives: Obstructive sleep apnea (OSA) is a disease that decreases the quality of sleep and increases morbidity. Positive airway pressure (PAP) treatment is known to be the most effective method in OSA. Since July 2018, the national health insurance has been applied to PAP, reducing the financial burden on patients. This study aims to examine the adherence of patients prescribed PAP before and after insurance and to analyze factors that have influence on the adherence.
Materials and Methods: As a retrospective study, the adherence of the group of patients who were prescribed PAP from July 2016 to June 2018, and the group from July 2018 to September 2020 after the insurance coverage was compared. A patient’s underlying disease, Epworth sleepiness scale (ESS) and polysomnography results, as well as PAP adherence for the 1st, 3rd, 6th, 9th month were examined.
Results: The patients were divided into pre- (pre-I, n=26) and post-national health insurance (post-I, n=168) groups. Mean age of each group was 47.3 (pre-I) vs. 49.6 (post-I) (p=0.240) and male:female ratio was 21:5 vs. 142:26 (p=0.158). ESS was 10.0 vs. 9.1 and apnea-hypopnea index was 52.8 vs. 50.5. Adherence of each month for pre-I and post-I was 73% vs. 67%, 71% vs. 64%, 53% vs. 46%, 44% vs. 41%. Patients with cerebrovascular accident were more adherent to PAP (p=0.000).
Conclusion: The adherence of PAP therapy might not be related with the insurance coverage for OSA patients.
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KEYWORD
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Sleep apnea, obstructive, Continuous positive airway pressure, Patient compliance, National health insurance
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