0429 ASSOCIATION BETWEEN HEALTHCARE COSTS AND CONTINUOUS POSITIVE AIRWAY PRESSURE ADHERENCE FOR TREATMENT OF OBSTRUCTIVE SLEEP APNEA

Abstract Introduction The impact of positive airway pressure (PAP) therapy on healthcare cost among patients with obstructive sleep apnea (OSA) requires further exploration. This study evaluated the associations between PAP adherence and in a large integrated system. Methods included adult OSA (apnea-hypopnea index (AHI) ≥5) available data 1/1/2015 to 8/31/2019 from Kaiser Permanente Southern California. We followed identified date highest AHI before use (index) up 2 years. Each patient had usage organized into 6-month intervals, mean hours/night was calculated for each interval. Patients were stratified following groups: (a) high (≥4 consistently across all intervals); (b) moderate (2–3.9 or ≥4 some but not (c) low (< hours/night). Healthcare costs (2020 US dollars) derived by assigning federal fee schedules utilization extracted electronic health records. associated estimated using generalized linear models adjusting demographics, comorbidities, Medicaid coverage, prior cost, AHI. Stratified analyses based age 65, ≥65 years) 15, ≥15) conducted. Results A total 25,700 (63.3% male; 41.6% ≥30) study. Among those, 53.2% (n=13,684) categorized as having adherence, 24.2% (n=6221) 22.5% (n=5795) adherence. High lowest average multivariable adjusted ($3,586, 95% CI: $3,428, $3,745) compared ($4,035, $3,859, $4,211) ($4,232, CI $4,110, $4,355) differences “high vs low” “moderate $646 (p< 0.001) $197 (p=0.050), respectively. $999 those years $657 ≥15. Conclusion Better significantly lower although understanding relationship is needed. Support (if any) KPSC Regional Research Committee Grant: KP-RRC-20210506.