Impact of treatment on healthcare resource utilization and cost of care among adults with obstructive sleep apnea and obesity.

BACKGROUND

Obstructive sleep apnea (OSA) disproportionately affects individuals with obesity and is associated with significant morbidity. The objective of this study was to estimate the cost of care and healthcare resource utilization among adults with OSA and obesity by OSA treatment status.

METHODS

This retrospective, longitudinal study used Optum's de-identified Market Clarity Data (Optum® Market Clarity) from Oct 2015 to Mar 2024. Adults (≥18 years old) with an OSA diagnosis, body mass index (BMI) ≥30 kg/m2 and apnea-hypopnea index (AHI) score ≥5 during the index period (Oct 2016-Dec 2022) were included. Individuals were also required to have continuous medical and pharmacy enrollment and no prior OSA treatment. Healthcare costs (excluding OSA-related treatment costs) and acute care events were evaluated during the 12-month follow-up period using generalized linear models, stratified by OSA treatment status.

RESULTS

The final sample included 10,116 individuals in the OSA-treated cohort and 3,881 individuals in the OSA-untreated cohort. In fully adjusted models, treated individuals had significantly lower least squares mean costs ($34,248 vs. $37,295, p = 0.0003) and had fewer acute care events, including emergency department (ED) visits and hospitalization days (0.87 vs. 1.09, p < 0.0001), compared to untreated individuals. They also had an 18% lower likelihood of ≥1 ED visit or day of hospitalization (odds ratio = 0.82; 95% confidence interval: 0.75, 0.89). Results were consistent across subgroups, including those with moderate-to-severe OSA and individuals with Medicare or commercial insurance.

CONCLUSION

These findings suggest that receiving treatment for OSA significantly reduces overall healthcare utilization among individuals with OSA and obesity.