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    The Impact of Treatments for OSA on Monetized Health Economic Outcomes: A Systematic Review

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    Author
    Wickwire, E.M.
    Albrecht, J.S.
    Towe, M.M.
    Date
    2019
    Journal
    Chest
    Publisher
    Elsevier Inc
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.chest.2019.01.009
    Abstract
    Objective: To review systematically the published literature regarding the impact of treatment for OSA on monetized health economic outcomes. Methods: Customized structured searches were performed in PubMed, Embase (Embase.com), and the Cochrane Central Register of Controlled Trials (Wiley) databases. Reference lists of eligible studies were also analyzed. Titles and abstracts were examined, and articles were identified for full-text review. Studies that met inclusion criteria were evaluated in detail, and study characteristics were extracted using a standardized template. Quantitative characteristics of the studies were summarized, and a qualitative synthesis was performed. Results: Literature searches identified 2,017 nonredundant abstracts, and 196 full-text articles were selected for review. Seventeen studies met inclusion criteria and were included in the final synthesis. Seven studies included formal cost-effectiveness or cost-utility analyses. Ten studies employed cohort designs, and four studies employed randomized controlled trial or quasi-experimental designs. Positive airway pressure was the most common treatment modality, but oral appliances and surgical approaches were also included. The most common health economic outcomes were health-care use (HCU) and quality-adjusted life years (QALYs). Follow-ups ranged from 6 weeks to 5 years. Overall, 15 of 18 comparisons found that treatment of OSA resulted in a positive economic impact. Treatment adherence and OSA severity were positively associated with cost-effectiveness. Conclusions: Although study methodologies varied widely, evidence consistently suggested that treatment of OSA was associated with favorable economic outcomes, including QALYs, within accepted ranges of cost-effectiveness, reduced HCU, and reduced monetized costs. Copyright 2019 The Authors
    Keyword
    accident risk
    CPAP
    economics
    health-care use
    sleep apnea
    sleep medicine
    treatment
    workplace productivity
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064550063&doi=10.1016%2fj.chest.2019.01.009&partnerID=40&md5=83345a904da9129a9ae64c85fb3f75d4; http://hdl.handle.net/10713/10787
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.chest.2019.01.009
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    UMB Open Access Articles 2019

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