Wait times for sleep apnea care in Ontario: a multidisciplinary assessment.
BACKGROUND
Obstructive sleep apnea (OSA) is a highly prevalent disorder that is associated with significant patient morbidity and societal burden. In general, wait times for health care in Ontario are believed to be lengthy; however, many diseases lack specific corroborative wait time data.


OBJECTIVE
To characterize wait times for OSA care in Ontario.


METHODS
Cross-sectional survey. A survey tool was designed and validated to question physicians involved in OSA care about the length of the wait times their patients experience while traversing a simplified model of OSA care. The survey was sent to all otolaryngologists and respirologists in the province, as well as to a random sample of provincial family physicians.


RESULTS
Patients waited a mean of 11.6 months to initiate medical therapy (continuous positive airway pressure), and 16.2 months to initiate surgical therapy. Sleep laboratory availability appeared to be the major restriction in the patient management continuum, with each additional sleep laboratory in a community associated with a 20% decrease in overall wait times. Smaller community sizes were paradoxically associated with shorter wait times for sleep studies (P<0.01) but longer wait times for OSA surgery (P<0.05). Regression analysis yielded an r2 of 0.046; less than 5% of the wait time variance could be explained by the simplified model.


CONCLUSIONS
Patients experienced considerable wait times when undergoing management for OSA. This has implications for both individual patient care and public health in general.
Rotenberg
Brian
B
Department of Otolaryngology-Head & Neck Surgery, University of Western Ontario, London, Ontario. brian.rotenberg@sjhc.london.on.ca
George
Charles
C
Sullivan
Kevin
K
Wong
Eric
E
D003430:Cross-Sectional Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010036:Otolaryngology / Q000706:statistics & numerical data*; D015272:Pulmonary Medicine / Q000706:statistics & numerical data*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000628:therapy*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014850:Waiting Lists
Thorax. 2001 Jul;56(7):508-12
11413347
Can Respir J. 2006 Oct;13(7):387-92
17036094
Lancet. 2005 Mar 19-25;365(9464):1046-53
15781100
Sleep. 2008 Aug;31(8):1067-8
18714776
Sleep. 1999 Sep 15;22(6):740-7
10505819
Healthc Policy. 2007 Feb;2(3):e140-54
19305710
Sleep. 2008 Aug;31(8):1079-85
18714779
Sleep. 1997 Aug;20(8):608-13
9351127
Sleep. 1999 Sep 15;22(6):749-55
10505820
N Engl J Med. 1993 Apr 29;328(17):1230-5
8464434
JAMA. 2000 Apr 12;283(14):1829-36
10770144
Sleep. 1997 Aug;20(8):645-53
9351133
Am J Respir Crit Care Med. 2004 Mar 15;169(6):668-72
15003950