title: Health care services utilization in children with obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  Little is known about the effects of obstructive sleep apnea syndrome (OSAS) on utilization of health care services in children. The present study compares medical service utilization by children with OSAS with that of healthy children.
  
  
  METHODS
  A cross-sectional study of 287 consecutively recruited children (1-18 years) with OSAS and no concomitant diseases and a control group matched by age, gender, and geographic location was conducted at the Clalit Health Care Services clinic in the southern region of Israel. Children in the study group underwent nocturnal polysomnography (PSG) studies. The control group (N = 1149) was randomly selected from the Clalit Health Care Services database. PSG was performed for the OSAS patients. Indices of health care utilization 1 year before the PSG study were analyzed.
  
  
  RESULTS
  A 226% increase in health care utilization was noted among children with OSAS. Children up to 5 years of age consumed more health care resources than children over 5 years. Children with OSAS consumed more health care services than the control group at all ages. The leading components of this high cost are utilization of more hospital days, drugs, and visits to the emergency department. The severity of the OSAS correlates directly to total annual costs and independently to age (beta = 0.19).
  
  
  CONCLUSIONS
  Children with OSAS are heavy consumers of health care services 1 year before any specific evaluation and treatment for apnea. Early diagnosis and intervention may be cost-effective.
authors.affiliation: Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Reuveni
authors.forename: Tzahit
authors.initials: T
authors.lastname: Simon
authors.forename: Asher
authors.initials: A
authors.lastname: Tal
authors.forename: Asher
authors.initials: A
authors.lastname: Elhayany
authors.forename: Ariel
authors.initials: A
authors.lastname: Tarasiuk
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D016527:Drug Costs; D017048:Health Care Costs; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay / Q000191:economics; D017286:Polysomnography / Q000706:statistics & numerical data; D011897:Random Allocation; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*