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DOI: 10.1055/s-2004-860895
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Disparities in Obstructive Sleep Apnea and Its Management between a Minority-Serving Institution and a Voluntary Hospital
Publikationsverlauf
Publikationsdatum:
20. Dezember 2004 (online)
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ABSTRACT
We assessed disparities in severity of obstructive sleep apnea (OSA) and associated comorbidities, as well as in provision of sleep medicine health care, between patients evaluated for OSA in a voluntary hospital (VH) primarily serving a middle-class population with health-care insurance and a city hospital-based minority-serving institution (MSI) largely treating lower income, uninsured, and indigent patients. A retrospective chart review of patients evaluated for OSA at the VH (n = 200) and at the MSI (n = 103) was performed. Despite similar age and apnea hypopnea index, MSI patients had a greater body mass index, higher daytime systemic blood pressure, more comorbid medical conditions, and a lower minimum sleep SaO2 than VH patients. Systemic hypertension, diabetes mellitus, asthma, and congestive heart failure were more prevalent in the MSI group. Forty-two percent of the MSI patients diagnosed with OSA failed to follow up for treatment compared with 7% in the VH group, p < 0.001. Disparities in OSA-associated comorbid conditions, as well as in delivery of sleep medicine-related health care, were evident between the VH and MSI groups. These findings suggest that OSA may be an important factor contributing to socioeconomic-based differences in morbidity and mortality.
KEYWORDS
Sleep apnea - socioeconomic status - disparity
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Harly GreenbergM.D.
Division of Pulmonary and Critical Care Medicine, Long Island Jewish Medical Center
New Hyde Park
NY 11040
eMail: greenber@lij.edu