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양압기 처방 보험 적용에 따른 순응도

Adherence Rate of Positive Airway Pressure after Korean National Health Insurance Coverage

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주제분류이비인후과학

초록

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.

Abstract

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.

참고문헌 (13)

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  7. 윤효은, "Improved Adherence to Positive Airway Pressure Treatment after Covering National Health Insurance in Patient with Obstructive Sleep Apnea: A Tertiary Sleep Center Review", Journal of sleep medicine, 18(1), pp.22~28 (2021), 대한수면연구학회[DOI]
  8. 최우리, "The Impact of National Health Insurance Coverage on Compliance With Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea", Clinical and Experimental Otorhinolaryngology, 15(1), pp.100~106 (2022), 대한이비인후과학회[DOI]
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  13. Drager LF, "Obstructive sleep apnea : a cardiometabolic risk in obesity and the metabolic syndrome", J Am Coll Cardiol, 62(7), pp.569~576 (2013)

관련 논문AI추천

The Impact of National Health Insurance Coverage on Compliance With Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea배미례, 정유삼, 최우리대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2022 · 제15권 제1호Improved Adherence to Positive Airway Pressure Treatment after Covering National Health Insurance in Patient with Obstructive Sleep Apnea: A Tertiary Sleep Center Review윤효은, 이호원, 전지예, 전창진, 황재춘대한수면연구학회 · Journal of sleep medicine2021 · 제18권 제1호건강 보험 적용하에 장기적으로 양압기 치료를 했던 폐쇄성 수면무호흡증 환자에서 중단 요인 분석김성동, 김현수, 박지환, 장서윤, 조규섭, 조현주대한이비인후과학회 부산,울산,경남 지부회 · 임상이비인후과2023 · 제34권 제2호폐쇄성 수면무호흡증 환자에서 양압기 치료에 대한 1년 이상 순응군과 비순응군의 비교금상연, 박진우, 박희준, 신승헌, 예미경, 유재호대한이비인후과학회 부산,울산,경남 지부회 · 임상이비인후과2022 · 제33권 제3호국민건강보험 급여화에 따른 수면무호흡증 관련 진료 현황김문정, 백현정, 이서영대한수면연구학회 · Journal of sleep medicine2020 · 제17권 제2호Predictors of Continuous Positive Airway Pressure Adherence and Comparison of Clinical Factors and Polysomnography Findings Between Compliant and Non-Compliant Korean Adults With Obstructive Sleep Apnea강승걸, Jae Myeong Kang, Joo Hyun Jung, Min Young Cho, Seo-Eun Cho, Seon Tae Kim, Yea Seol Lee대한신경정신의학회 · PSYCHIATRY INVESTIGATION2024 · 제21권 제2호

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