title: Continuous Positive Airway Pressure Device Time to Procurement in a Disadvantaged Population.
abstract: Introduction. The management of obstructive sleep apnea (OSA) in patients who cannot afford a continuous positive airway pressure (CPAP) device is challenging. In this study we compare time to CPAP procurement in three groups of patients diagnosed with OSA: uninsured subsidized by a humanitarian grant (Group 1), uninsured unsubsidized (Group 2), and those with Medicare or Medicaid (Group 3). We evaluate follow-up and adherence in Group 1. We hypothesize that additional factors, rather than just the ability to obtain CPAP, may uniquely affect follow-up and adherence in uninsured patients. Methods. 30 patients were in Groups 1 and 2, respectively. 12 patients were in Group 3. Time of CPAP procurement from OSA diagnosis to CPAP initiation was assessed in all groups. CPAP adherence data was collected for Group 1 patients at 1, 3, 6, and 9 months. Results. There were no significant differences between groups in gender, age, body mass index, or apnea hypopnea index. The mean time to procurement in Group 1 was shorter compared to Group 2 but not significant. Compared to both Group 1 and Group 2, Group 3 patients had significantly shorter times to device procurement. Conclusion. Time to procurement of CPAP was significantly shorter in those with Medicaid/Medicare insurance compared to the uninsured.
authors.affiliation: Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA 71103, USA ; Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
authors.forename: Lourdes M
authors.initials: LM
authors.lastname: DelRosso
authors.affiliation: Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA 71103, USA ; Emory Sleep Center, Department of Neurology, Emory University School of Medicine, Atlanta, GA 30329, USA.
authors.forename: Romy
authors.identifier: 0000-0003-3989-1069
authors.initials: R
authors.lastname: Hoque
authors.affiliation: Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA 71103, USA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Chesson