title: Obstructive sleep apnea syndrome in a publicly funded healthcare system.
abstract: BACKGROUND
  Despite its current recognition as a major health concern, little has been published about obstructive sleep apnea syndrome (OSAS) as a health problem in public healthcare systems where limited resources, language and cultural differences may present barriers to detection and treatment.
  
  
  OBJECTIVE
  To describe patients referred for suspected OSAS in a large county-funded healthcare system.
  
  
  METHODS
  A retrospective, descriptive observational study that included all patients referred for an OSAS evaluation between September 2000 and September 2002.
  
  
  RESULTS
  Only 123 patients were referred and 115 completed an evaluation during the two-year period: 99% met OSAS diagnostic criteria, which was severe in 79% and frequently complicated by related comorbid conditions. CPAP acceptance was lower than in the previous series, especially among Hispanics.
  
  
  CONCLUSIONS
  The findings suggest that referral for OSAS evaluation was limited to those most severely affected and raise the possibility of underdetection and undertreatment in the ublic sector.
authors.affiliation: Pulmonary and Critical Care Division, University of California, Irvine Medical Center, Orange, CA, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Tran
authors.forename: Jeanne
authors.initials: J
authors.lastname: Wallace
mesh_terms: D002140:California / Q000453:epidemiology; D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data; D005260:Female; D005380:Financing, Government; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data; D044469:Racial Groups; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*