Lessons from healthcare utilization in children with obstructive sleep apnoea syndrome

Abstract

Introduction and objectives: Paediatric Obstructive Sleep Apnoea-Hypopnoea Syndrome (OSAS) is a multisystemic condition affecting child's health status that may be investigated analyzing demand for healthcare.

Objective: to quantify the frequency of medical consultations in children with OSAS over a 5-year period, compared to a healthy population.

Methods: A longitudinal, case-control, ambispective study was conducted at a hospital pertaining to the national public health system. 69 consecutive children referred for OSAS were recruited with no diseases other than OSAS so that healthcare demand was purely attributed to this condition. Matched healthy control children were selected to compare these data. Data regarding frequency of the medical consultations were obtained over 5 years: the year of the treatment ("Year0"), 1 and 2 years before ("Year -1" and "Year -2" respectively), and 1 and 2 years after treatment ("Year+1" and "Year+2") RESULTS: Frequentation Index (FI), as ratio between the use of health services by OSAS children and healthy controls was 1.89 during Year-2, and 2.15 during Year-1 (P<.05). Treatment diminishes utilization, with FI of 159 during year+1 and 1.72 during year+2 (P<.05). The main causes of attendance were otolaryngological and pneumological diseases, improving after treatment.

Conclusions: Children suffering from OSAS demand more healthcare services, at least 2 years before treatment, implying that the disease could be present years before we manage it. Therapeutic actions improve healthcare services utilization, although remain higher than for controls, which suggests OSAS sequelae or residual disease.

Keywords: Child health; Health care utilization; Health services needs and demand; Necesidad y demanda de servicios de salud; Salud del niño; Sleep apnoea syndromes; Síndrome de apnea del sueño obstructiva; Utilización de servicios de salud.