OSA and Hospital Readmission Rates
To fully understand the relationship between obstructive sleep apnea (OSA) and hospital readmission rates, it is necessary to understand the serious comorbidities associated with this chronic health condition. Because OSA is characterized by repeated interruptions in breathing during sleep, untreated sleep apnea has been linked to serious cardiovascular illnesses, including high blood pressure, arrhythmia, stroke, and heart failure. These same cardiovascular comorbidities are among the most frequent causes of hospital readmissions.
According to the American Academy of Sleep Medicine, over 30 million people in the U.S. suffer from obstructive sleep apnea, the most prevalent type of sleep apnea. In addition to cardiovascular illnesses, OSA has other serious comorbidities, including diabetes, obesity, and depression. But the cardiovascular-OSA connection is perhaps most prevalent because, of the 92 million people who suffer from cardiovascular disease, 60% also suffer from sleep apnea.
Hospital readmission rates are an important indicator of the quality of patient care received, but they also bring to light the enormous cost associated with readmissions. According to the website Modern Healthcare, hospital readmissions cost the U.S. as much as $25 billion annually. The standard metric used to define hospital readmission is the 30-day readmission rate defined by the Centers for Medicare & Medicaid Services (CMS). The most common conditions associated with hospital readmissions include cardiac arrhythmias, COPD, congestive heart failure, and pneumonia, which are also all comorbidities of OSA.
A study published in the NIH National Library of Medicine examined a large cohort of cardiac surgical patients between 2007 and 2014 to research the relationship between OSA and hospital readmission rates. The cohort included over 300,000 cardiac patients who underwent coronary artery bypass grafting surgery (CABG) and/or valve surgery. The study concluded that patients with OSA had higher odds of 30-day readmission and a greater risk of developing postoperative atrial fibrillation than patients who did not present with OSA.
In 2018, a study published in the journal Chest was conducted to analyze the readmission rates for patients with COPD (chronic obstructive pulmonary disease). While the cohort was just under 300 patients, the findings were significant. The study concluded that OSA was prevalent for patients admitted for COPD and increased the likelihood of hospital readmission more than threefold.
The Journal of Sleep Medicine published a study that sheds light on how CPAP, or continuous positive airway pressure therapy, is significantly associated with a decrease in 30-day hospital readmissions. CPAP therapy is the gold standard when it comes to OSA care. It uses pressurized air delivered through a mask to open blocked airways, allowing for better, uninterrupted sleep. The study of 345 patients was divided equally between adherent and non-adherent CPAP users. The findings showed that non-adherent patients were three times more likely than adherent patients to be readmitted to the hospital within 30 days for any reason. They were also two times more likely to be readmitted due to cardiovascular conditions.
Obstructive sleep apnea has a strong correlation to hospital readmissions due to its many comorbidities. The very illnesses associated with OSA are the same conditions that are the most prevalent reasons for hospital readmissions. By first treating their OSA, patients have not only a better chance of avoiding the serious conditions associated with this sleep health issue, but they can also reduce the risk of hospital readmission.
To learn more about how BetterNight can help you provide more effective and efficient care to your at-risk sleep apnea patients, contact us.