Changes in Patients Who Receive Coverage for Positive Airway Pressure Therapy According to Alterations in National Health Insurance Benefit Standards for Mild Obstructive Sleep Apnea
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Background and Objectives The aim of this study was to identify the frequency of indica-tors of National Health Insurance (NHI) coverage for positive airway pressure (PAP) therapyand to investigate the changes in patients receiving coverage for PAP therapy after the altera-tions were made in the insurance benefit standards for mild obstructive sleep apnea (OSA). Subjects and Method We divided the mild OSA patients into two groups according to al-tered categorization in insurance benefit standards (Mild1: 5≤AHI<10; Mild2: 10≤AHI<15). Eight indicators related to the NHI coverage were identified: four symptoms, three complica-tions, and the minimal blood oxygen saturation during polysomnography (min SpO2) of ≤85%during polysomnography. We also investigated the change in the number of patients receivinginsurance benefits under the altered insurance benefit standards. Results Of the 233 OSA patients, 66, 57, and 110 patients were diagnosed as mild, moderateand severe OSA, respectively. For all of them, the most common indicator related to NHI cov-erage for PAP therapy was the minimum SpO2 of less than 85% during polysomnography, andthe second most common indicator was daytime sleepiness. In the mild OSA group, however,daytime sleepiness was found to be the most common indicator, found in 46 (70%) patients,followed by 38 (58%) patients with min SpO2 of less than 85%. In this group, 59 (89.4%)would have been benefited before the change in the insurance benefit standards whereas 51patients (77.3%) would now be benefited under the changed insurance benefit standards. Conclusion Daytime sleepiness was the most commonly observed indicator in the mildOSA patients. The number of patients receiving insurance benefits for PAP therapy significantlydecreased after the change was made in the NHI benefit standards for mild OSA.
Abstract
Background and Objectives The aim of this study was to identify the frequency of indica-tors of National Health Insurance (NHI) coverage for positive airway pressure (PAP) therapyand to investigate the changes in patients receiving coverage for PAP therapy after the altera-tions were made in the insurance benefit standards for mild obstructive sleep apnea (OSA). Subjects and Method We divided the mild OSA patients into two groups according to al-tered categorization in insurance benefit standards (Mild1: 5≤AHI<10; Mild2: 10≤AHI<15). Eight indicators related to the NHI coverage were identified: four symptoms, three complica-tions, and the minimal blood oxygen saturation during polysomnography (min SpO2) of ≤85%during polysomnography. We also investigated the change in the number of patients receivinginsurance benefits under the altered insurance benefit standards. Results Of the 233 OSA patients, 66, 57, and 110 patients were diagnosed as mild, moderateand severe OSA, respectively. For all of them, the most common indicator related to NHI cov-erage for PAP therapy was the minimum SpO2 of less than 85% during polysomnography, andthe second most common indicator was daytime sleepiness. In the mild OSA group, however,daytime sleepiness was found to be the most common indicator, found in 46 (70%) patients,followed by 38 (58%) patients with min SpO2 of less than 85%. In this group, 59 (89.4%)would have been benefited before the change in the insurance benefit standards whereas 51patients (77.3%) would now be benefited under the changed insurance benefit standards. Conclusion Daytime sleepiness was the most commonly observed indicator in the mildOSA patients. The number of patients receiving insurance benefits for PAP therapy significantlydecreased after the change was made in the NHI benefit standards for mild OSA.
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