National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Asthma (2)
- Back Health and Pain (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Brain Injury (2)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Children/Adolescents (7)
- Chronic Conditions (4)
- Critical Care (1)
- Cultural Competence (1)
- Decision Making (1)
- Dental and Oral Health (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Elderly (2)
- Evidence-Based Practice (2)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (3)
- Healthcare Utilization (1)
- Health Promotion (1)
- Heart Disease and Health (1)
- Hospitalization (4)
- Hospital Readmissions (1)
- Hospitals (2)
- Implementation (1)
- Injuries and Wounds (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (1)
- Medical Errors (1)
- Medicare (5)
- Medication (1)
- Neurological Disorders (4)
- Outcomes (2)
- Pain (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Experience (1)
- Patient Safety (1)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Care (2)
- Quality of Life (3)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (9)
- Risk (1)
- Skin Conditions (5)
- (-) Sleep Problems (26)
- Surgery (2)
- Training (1)
- Trauma (2)
- Treatments (1)
- Vulnerable Populations (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedRumble DD, O'Neal K, Overstreet DS
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
This study compared associations between neighborhood-level socioeconomic status (SES), pain-status (chronic low back pain vs. pain-free), and daily sleep metrics in 117 adults. With neighborhood-level SES gathered from Neighborhood Atlas, and with individuals completing home sleep monitoring for 7 consecutive days/nights, analyses revealed neighborhood-level SES and neighborhood-level SES pain-status interaction significantly impacted objective sleep quality.
AHRQ-funded; HS013852.
Citation: Rumble DD, O'Neal K, Overstreet DS .
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
J Behav Med 2021 Dec;44(6):811-21. doi: 10.1007/s10865-021-00234-w..
Keywords: Sleep Problems, Back Health and Pain, Chronic Conditions, Pain
Hirayama A, Goto T, Faridi MK
Association of obstructive sleep apnea with all-cause readmissions after hospitalization for asthma exacerbation in adults aged 18-54 years: a population-based study, 2010-2013.
The authors sought to investigate associations between obstructive sleep apnea (OSA) and readmission risk after hospitalization for asthma exacerbation using data from State Inpatient Databases from seven U.S. states. They found that, overall, OSA was associated with a significantly higher incident rate of all-cause readmission. Additionally, OSA was associated with higher incident rates of readmissions for five major diseases: asthma, COPD, respiratory failure, pneumonia, and congestive heart failure, compared to non-OSA.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Faridi MK .
Association of obstructive sleep apnea with all-cause readmissions after hospitalization for asthma exacerbation in adults aged 18-54 years: a population-based study, 2010-2013.
J Asthma 2021 Sep;58(9):1176-85. doi: 10.1080/02770903.2020.1781887..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sleep Problems, Hospital Readmissions, Asthma, Respiratory Conditions, Chronic Conditions
Xu L, Xie D, Griffin KS
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
Although mandibular advancement device (MAD) treatment of adults with obstructive sleep apnea (OSA) is generally less efficacious than positive airway pressure (PAP), the two treatments are associated, with similar clinical outcomes. As a sub-analysis of a randomized trial comparing the effect of MAD versus PAP on blood pressure, this study compared objectively measured adherence to MAD versus PAP treatment in adults with OSA.
AHRQ-funded; HS019738.
Citation: Xu L, Xie D, Griffin KS .
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
J Sleep Res 2021 Aug;30(4):e13240. doi: 10.1111/jsr.13240..
Keywords: Sleep Problems, Patient Adherence/Compliance, Treatments, Dental and Oral Health, Respiratory Conditions
Fishbein AB, Cheng BT, Tilley CC
Sleep disturbance in school-aged children with atopic dermatitis: prevalence and severity in a cross-sectional sample.
The authors sought to estimate the US prevalence of sleep disturbance and its impact on psychological and neurocognitive function in patients with atopic dermatitis (AD). Using PROMIS (Patient Reported Outcome Measurement Information System), they found that sleep disturbance was a common symptom of AD affecting approximately 3 million US children and was associated with neuropsychiatric impairment, including depression, anxiety, and inattention. They recommended that clinicians screen for these symptoms in school-aged children, particularly with moderate-to-severe AD.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Cheng BT, Tilley CC .
Sleep disturbance in school-aged children with atopic dermatitis: prevalence and severity in a cross-sectional sample.
J Allergy Clin Immunol Pract 2021 Aug;8(8):3120-29.e3. doi: 10.1016/j.jaip.2021.04.064..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Alcántara C, Giorgio Cosenzo L, McCullough E
Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: a systematic review of randomized controlled trials in the United States.
This systematic review examined behavioral randomized controlled trials (RCTs) on prevalent sleep-wake disorders and sleep disturbances to determine if these studies targeted underserved populations or addressed contextual and cultural factors. The authors examined sociodemographic characteristics of behavioral RCTs that targeted underserved adults, identified types of cultural adaptations (surface-level or deep-level), and described intervention effectiveness on primary sleep outcomes. Overall out of 56 studies, 6.97% targeted underserved groups (veterans, women, racial/ethnic minorities, low socioeconomic status, disability status); and 64.9% made surface-level or deep-level cultural adaptations. Most cultural adaptions were made to behavioral therapies, and cognitive behavioral therapy for insomnia (CBT-I). Surface-level cultural adaptions made were mostly to the delivery modality and setting. Deep-level cultural adaptations to the content and core intervention components were the most typical. Intervention effectiveness varied by type of adapted intervention and the participant population. RCTs including adapted CBT-I interventions among participants showed consistent significant reductions in adverse sleep outcomes versus control.
AHRQ-funded; HS024274.
Citation: Alcántara C, Giorgio Cosenzo L, McCullough E .
Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: a systematic review of randomized controlled trials in the United States.
Sleep Med Rev 2021 Apr;56:101455. doi: 10.1016/j.smrv.2021.101455..
Keywords: Sleep Problems, Cultural Competence, Behavioral Health, Racial and Ethnic Minorities, Vulnerable Populations
Makarem N, Alcántara C, Williams N
Effect of sleep disturbances on blood pressure.
This review summarizes recent literature addressing the association of short sleep duration, shift work, and obstructive sleep apnea with hypertension risk, blood pressure (BP) levels, and 24-hour ambulatory BP. Recommendations include efforts to educate patients and health care providers about the importance of identifying and treating sleep disturbances for hypertension prevention and management. Empirically supported sleep health interventions represent a critical next step to advance this research area and establish causality.
AHRQ-funded; HS024274.
Citation: Makarem N, Alcántara C, Williams N .
Effect of sleep disturbances on blood pressure.
Hypertension 2021 Apr;77(4):1036-46. doi: 10.1161/hypertensionaha.120.14479..
Keywords: Sleep Problems, Blood Pressure, Respiratory Conditions
Leu GR, Links AR, Ryan MA
Assessment of parental choice predisposition for tonsillectomy in children.
The decision to proceed with tonsillectomy to treat pediatric obstructive sleep-disordered breathing (OSDB) often falls on individual families. Despite emphasis on shared decision-making between parents and surgeons about tonsillectomy for OSDB, the extent to which parents have already decided about surgery prior to the child's consultation is not known. The objective of this study was to identify predictors of parent choice predisposition for surgical treatment of OSDB with tonsillectomy and describe its association with parent-clinician communication.
AHRQ-funded; HS022932.
Citation: Leu GR, Links AR, Ryan MA .
Assessment of parental choice predisposition for tonsillectomy in children.
JAMA Otolaryngol Head Neck Surg 2021 Mar;147(3):263-70. doi: 10.1001/jamaoto.2020.5031..
Keywords: Children/Adolescents, Caregiving, Decision Making, Surgery, Sleep Problems, Respiratory Conditions
Lei DK, Yousaf M, Janmohamed SR
Validation of patient-reported outcomes information system sleep disturbance and sleep-related impairment in adults with atopic dermatitis.
This study examined the measurement properties of the Patient-Reported Outcomes Measurement System (PROMIS) Sleep Disturbance (SD) and Sleep-Related Impairment (SRI) questionnaires to assess sleep disturbances in adults with atopic dermatitis (AD). The authors performed a prospective dermatology-practice-based study using questionnaires and evaluation by a dermatologist (n=420). Both questionnaires showed good construct validity, internal consistency, and feasibility to assess sleep in patients with AD.
AHRQ-funded; HS023011.
Citation: Lei DK, Yousaf M, Janmohamed SR .
Validation of patient-reported outcomes information system sleep disturbance and sleep-related impairment in adults with atopic dermatitis.
Br J Dermatol 2020 Nov;183(5):875-82. doi: 10.1111/bjd.18920..
Keywords: Sleep Problems, Skin Conditions
Luther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
This study examined sleep quality and barriers to sleep among adult hospital inpatients recovering from elective surgery. A quantitative survey was used followed by a qualitative phone interview with a subsample of participants. Of 113 eligible patients, 102 (90%) completed the survey. Less than half reported sleeping well the night prior to surgery and 93% reported less sleep in the hospital compared to home. A median of 5 (4-7) interruptions were reported each night. Patients with more than three interruptions were likely to report poor sleep compared with those who had three or less. Barriers to sleep included staff interruptions and roommate noise but not pain. Patients interviewed suggested improved timing and knowledge of interruptions or use of noise-reduction aids that would facilitate sleep.
AHRQ-funded; HS026030.
Citation: Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R .
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
J Surg Res 2020 Oct;254:268-74. doi: 10.1016/j.jss.2020.04.032..
Keywords: Sleep Problems, Surgery, Quality Improvement, Quality of Care, Inpatient Care, Hospitals, Patient Experience
Poppert Cordts KM, Hall TA, Hartman ME
Sleep measure validation in a pediatric neurocritical care acquired brain injury population.
Lingering morbidities including physical, cognitive, emotional, and psychosocial sequelae, termed the Post-Intensive Care Syndrome, persist years after pediatric neurocritical care (PNCC) hospitalization. Sleep disturbances impact other Post-Intensive Care Syndrome domains and are under-evaluated to date due to a lack of appropriate measurement tools. The present study evaluated the validity of the Sleep Disturbance Scale for Children (SDSC) to address the growing need for assessing sleep problems after PNCC.
AHRQ-funded; HS022981.
Citation: Poppert Cordts KM, Hall TA, Hartman ME .
Sleep measure validation in a pediatric neurocritical care acquired brain injury population.
Neurocrit Care 2020 Aug;33(1):196-206. doi: 10.1007/s12028-019-00883-5..
Keywords: Children/Adolescents, Sleep Problems, Neurological Disorders, Intensive Care Unit (ICU), Hospitalization, Quality of Life
Lei D, Yousaf M, Janmohamed SR
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
The purpose of this study was to assess the measurement properties of sleep-related items from the Patient-Oriented Eczema Measure (POEM), SCORing AD (SCORAD), 5-dimensions of itch (5D), and Itch-Related Quality of Life (ItchyQOL) in adults with atopic dermatitis (AD). Results showed modest overlap and weak to moderate concordance of responses to the different assessments. The researchers conclude that sleep-related items from POEM, SCORAD, 5D, and ItchyQOL showed good validity and responsiveness to monitor sleep disturbances in adult AD patients.
AHRQ-funded; HS023011.
Citation: Lei D, Yousaf M, Janmohamed SR .
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
Ann Allergy Asthma Immunol 2020 Mar;124(3):261-66. doi: 10.1016/j.anai.2019.12.002..
Keywords: Sleep Problems, Skin Conditions, Quality of Life, Patient-Centered Outcomes Research
McKenzie C, Paller AS, Fishbein A
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
Atopic dermatitis (AD) is a chronic inflammatory skin disease impacting 13% of children in the United States. It is associated with sleep disturbances. In this paper the investigators sought to examine the associations of AD onset, AD persistence, and comorbid atopic conditions with sleep disturbance and overall health in childhood. This study added to previous studies by demonstrating that comorbid atopy and AD course, particularly early-onset and more persistent AD, were associated with sleep disturbance.
AHRQ-funded; HS023011.
Citation: McKenzie C, Paller AS, Fishbein A .
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
J Allergy Clin Immunol Pract 2020 Feb;8(2):812-14.e1. doi: 10.1016/j.jaip.2019.08.027..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Oka S, Goto T, Hirayama A
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Researchers investigated the association of obstructive sleep apnea (OSA) with acute asthma severity in a retrospective cohort study that used State Inpatient Databases from eight geographically diverse states. Outcomes examined were markers of acute severity such as mechanical ventilation use, hospital length of stay, and in-hospital mortality. The researchers found that, among patients hospitalized for acute asthma, OSA was associated with a higher risk of noninvasive positive pressure ventilation use and longer length of stay compared with those without OSA.
AHRQ-funded; HS023305.
Citation: Oka S, Goto T, Hirayama A .
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sleep Problems, Asthma, Respiratory Conditions, Hospitalization
Albrecht JS, Wickwire EM
Sleep disturbances among older adults following traumatic brain injury.
The objective of this study was to assess the risk of newly diagnosed sleep disorders following traumatic brain injury (TBI) among adults aged 65 and older. Subjects diagnosed with TBI and non-TBI controls were identified through a large commercial insurance database. Results showed that TBI was associated with an increased risk of insomnia and any sleep disorder. Recommendations included following TBI among older adults, screening, and education on sleep disorders.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Wickwire EM .
Sleep disturbances among older adults following traumatic brain injury.
Int Rev Psychiatry 2020 Feb;32(1):31-38. doi: 10.1080/09540261.2019.1656176..
Keywords: Elderly, Sleep Problems, Neurological Disorders
Williams CN, Hartman ME, McEvoy CT
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Sleep-wake disturbances are underevaluated among children with acquired brain injury surviving critical care. In this prospective cohort study, the investigators aimed to quantify severity, phenotypes, and risk factors for sleep-wake disturbances. The investigators concluded that over half of children surviving critical care with acquired brain injury have sleep-wake disturbances. They indicated that many sleep-wake disturbances phenotypes were identified, but most children had disturbance in initiation and maintenance of sleep.
AHRQ-funded; HS022981.
Citation: Williams CN, Hartman ME, McEvoy CT .
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Pediatr Neurol 2020 Feb;103:43-51. doi: 10.1016/j.pediatrneurol.2019.08.010..
Keywords: Children/Adolescents, Brain Injury, Critical Care, Sleep Problems, Trauma, Injuries and Wounds, Neurological Disorders
Wickwire EM, Vadlamani A, Tom SE
Economic aspects of insomnia medication treatment among Medicare beneficiaries.
The purpose of this study was to examine economic aspects of insomnia and insomnia medication treatment among a nationally representative sample of older adult Medicare beneficiaries. A total of 23,079 beneficiaries with insomnia were included. Of these, 5,154 (22%) received >1 fills for an FDA-approved insomnia medication following insomnia diagnosis. For both treated and untreated individuals, healthcare utilization and costs increased during the 12 months prior to diagnosis. Insomnia treatment was associated with significantly increased ED visits and prescription fills in the year following insomnia diagnosis.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Vadlamani A, Tom SE .
Economic aspects of insomnia medication treatment among Medicare beneficiaries.
Sleep 2020 Jan;43(1):pii: zsz192. doi: 10.1093/sleep/zsz192..
Keywords: Medication, Sleep Problems, Medicare, Healthcare Costs
Sterling MR, Echeverria SE, Commodore-Mensah Y
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
This article discusses the key themes from a 2-day workshop that was held at the National Institutes of Health in May 2018 to promote health equity and implementation science in heart, lung, and sleep-related research. This inaugural workshop was named the Saunders-Watkins Leadership Workshop. Recommendations are offered for the future direction of this research.
AHRQ-funded; HS000066.
Citation: Sterling MR, Echeverria SE, Commodore-Mensah Y .
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
Circ Cardiovasc Qual Outcomes 2019 Oct;12(10):e005586. doi: 10.1161/circoutcomes.119.005586..
Keywords: Implementation, Evidence-Based Practice, Disparities, Patient-Centered Outcomes Research, Cardiovascular Conditions, Heart Disease and Health, Respiratory Conditions, Sleep Problems
Treister AD, Stefek H, Grimaldi D
Sleep and limb movement characteristics of children with atopic dermatitis coincidentally undergoing clinical polysomnography.
Atopic dermatitis (AD) is a prevalent, chronic, itchy skin condition. Children undergoing polysomnography (PSG) may coincidentally have AD. Many children with AD have sleep disturbances. This study aimed to characterize limb movements in children with AD and their effect on sleep. The investigators found altered PSG parameters in children with AD, suggesting that clinicians should consider the diagnosis when affected children undergo PSG.
AHRQ-funded; HS023011.
Citation: Treister AD, Stefek H, Grimaldi D .
Sleep and limb movement characteristics of children with atopic dermatitis coincidentally undergoing clinical polysomnography.
J Clin Sleep Med 2019 Aug 15;15(8):1107-13. doi: 10.5664/jcsm.7800..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Ye L, Owens RL, Dykes P
Individualized sleep promotion in acute care hospitals: Identifying factors that affect patient sleep.
The aim of this study was develop a tool that can be used to measure factors that affect patient sleep in acute care hospitals. A tool called Factors Affected Inpatient Sleep (FAIS) was developed using literature review and was validated by content validity testing. The scale was tested on 105 hospitalized patients and the most significant sleep disruptors were identified. The final FAIS scale included 14 items in three subscales. The biggest factors for sleep disruption included 1) emotional or physical impairment due to illness or hospitalization; 2) sleep disturbance due to discomfort of their care plan schedule; and 3) sleep interruption due to the hospital environment or medical care. The reliability of the scale was measured at 0.87 with Cronbach’s alpha coefficient and reliability of the subscales ranged from 0.72 to 0.81.
AHRQ-funded; HS024330.
Citation: Ye L, Owens RL, Dykes P .
Individualized sleep promotion in acute care hospitals: Identifying factors that affect patient sleep.
Appl Nurs Res 2019 Aug;48:63-67. doi: 10.1016/j.apnr.2019.05.006..
Keywords: Health Promotion, Hospitalization, Hospitals, Inpatient Care, Sleep Problems
St Hilaire MA, Anderson C, Anwar J
Brief (<4 hour) sleep episodes are insufficient for restoring performance in first-year resident physicians working overnight extended-duration work shifts.
This study examines the impact of reinstating extended duration (24-28) work shifts (EDWS) for postgraduate year 1 resident physicians. The performance of residents was studied for 23 male residents between 2002-2004 during a three-week on-call rotation schedule at the Medical and Intensive Care Units at Brigham and Women’s Hospital in Boston. If the sleep episodes were four hours or less then the odds of >1 attentional failure was 2.72 times higher during post-call compared to matched sessions during non-EDWS.
AHRQ-funded; HS012032.
Citation: St Hilaire MA, Anderson C, Anwar J .
Brief (<4 hour) sleep episodes are insufficient for restoring performance in first-year resident physicians working overnight extended-duration work shifts.
Sleep 2019 May;42(5):pii: zsz041. doi: 10.1093/sleep/zsz041..
Keywords: Adverse Events, Education: Continuing Medical Education, Medical Errors, Patient Safety, Provider, Provider: Physician, Quality of Care, Sleep Problems, Training
Wickwire EM, Albrecht JS, Towe MM
The impact of treatments for OSA on monetized health economic outcomes: a systematic review.
This article systematically reviews published literature on the impact of treatment for obstructive sleep apnea (OSA) on monetized health economic outcomes. Customized searches were conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases; 196 articles were selected for review, and 17 studies met the inclusion criteria and were included in the final synthesis. In these selected studies, positive airway pressure was the most common treatment modality, but oral appliances and surgical approaches were also included. Healthcare use (HCU) and quality-adjusted life years (QALYs) were most common health economic outcomes. The authors conclude that, although study methodologies varied widely, the evidence suggested that treatment of OSA was associated with favorable economic outcomes within accepted ranges of cost-effectiveness, as well as reduced HCU and monetized costs.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Albrecht JS, Towe MM .
The impact of treatments for OSA on monetized health economic outcomes: a systematic review.
Chest 2019 May;155(5):947-61. doi: 10.1016/j.chest.2019.01.009..
Keywords: Sleep Problems, Respiratory Conditions, Healthcare Costs, Outcomes
Wickwire EM, Tom SE, Scharf SM
Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries.
The purpose of this study was to examine the impact of untreated insomnia on health care utilization (HCU) among a representative sample of Medicare beneficiaries. Insomnia was defined as the presence of at least one claim containing an insomnia-related diagnosis in any given year based on ICD-9 or at least one prescription filled for an insomnia-related medication in Part D prescription drug files. Researchers compared HCU in the year prior to insomnia diagnosis with non-sleep disordered controls during the same period. The researchers conclude that the individuals in this randomly selected, representative sample with untreated insomnia demonstrated increased HCU and costs across all points of service.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Tom SE, Scharf SM .
Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries.
Sleep 2019 Apr;42(4). doi: 10.1093/sleep/zsz007..
Keywords: Healthcare Costs, Healthcare Utilization, Medicare, Sleep Problems
Singh G, Agarwal A, Zhang W
Impact of PAP therapy on hospitalization rates in Medicare beneficiaries with COPD and coexisting OSA.
This retrospective cohort study analyzed data from a national sample of fee-for-service Medicare beneficiaries with a diagnosis of chronic obstructive pulmonary disease (COPD) and coexisting obstructive sleep apnea (OSA) who had begun positive airway pressure (PAP) therapy in 2011. The effect of PAP therapy on emergency room visits and hospitalizations for all-cause and COPD-related conditions was also examined. PAP therapy was more beneficial for older adults, those with higher COPD complexity, and those with three or more comorbidities. PAP therapy in elderly patients with overlap syndrome is associated with a reduction in hospitalization for COPD-related conditions, but not for all-cause hospitalizations or ER visits.
AHRQ-funded; HS020642; HS022134.
Citation: Singh G, Agarwal A, Zhang W .
Impact of PAP therapy on hospitalization rates in Medicare beneficiaries with COPD and coexisting OSA.
Sleep Breath 2019 Mar;23(1):193-200. doi: 10.1007/s11325-018-1680-0..
Keywords: Respiratory Conditions, Sleep Problems, Hospitalization, Medicare, Chronic Conditions
Albrecht JS, Wickwire EM, Vadlamani A
Trends in insomnia diagnosis and treatment among Medicare beneficiaries, 2006-2013.
In this study, the investigators examined trends in insomnia diagnosis and treatment among Medicare beneficiaries over an eight-year period. In this large national analysis of Medicare beneficiaries, prevalence of physician-assigned insomnia diagnoses was low but increased over time. Prevalence of insomnia medication use was up to four-times higher than insomnia diagnoses and remained steady over time.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Wickwire EM, Vadlamani A .
Trends in insomnia diagnosis and treatment among Medicare beneficiaries, 2006-2013.
Am J Geriatr Psychiatry 2019 Mar;27(3):301-09. doi: 10.1016/j.jagp.2018.10.017..
Keywords: Diagnostic Safety and Quality, Elderly, Medicare, Sleep Problems