[Cost-benefit analysis in patients with sleep-related breathing disorders - diagnosis and ncpap therapy during medical rehabilitation].
In a multi-centre study, 745 patients undergoing internal medical rehabilitation (for hypertension, coronary heart disease, gastrointestinal and respiratory diseases) were investigated. The health economic benefit was evaluated during the 3 weeks of medical rehabilitation, during which a sleep-medical diagnostic work-up and treatment were applied. Ambulatory screening for sleep-related breathing disorders was carried out in all patients. In positive cases (Apnoea-Hypopnoea Index > or = 10) transfer to our sleep lab was recommended. 103 patients were found to be positive, of whom 47 attended the lab; 23 of these accepted nCPAP therapy, while 24 did not. The costs of the additional diagnosis and treatment were considered incremental costs--and the benefit identified as the decrease in days off work as revealed by a comparison of the year before with the year after rehabilitation. Days off work decreased by 38.4 days in the treated group, and increased by 25.4 days in the untreated group. The results were extrapolated to all patients in internal medical rehabilitation in Germany, and a cost-benefit analysis showed that the benefit of expanding the additional investigation to cover all patients would far exceed the incremental costs in the first year after rehabilitation by 58.26 Mio [symbol: see text] and in the second year by 81.15 Mio. [symbol: see text].
Fischer
J
J
Institut für Rehaforschung, Klinik Norderney, Universität Witten/Herdecke, Norderney. fischer-norderney@t-online.de
Raschke
F
F
D045422:Continuous Positive Airway Pressure / Q000191:economics* / Q000379:methods*; D005260:Female; D005858:Germany; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D008297:Male; D018582:Sick Leave / Q000191:economics*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000191:economics* / Q000534:rehabilitation*