A poster titled, “Sleep Testing During the Pandemic” has been presented at AcademyHealth: Dissemination & Implementation. The study was conducted as a part of the outcomes research collaboration between HealthHelp and Humana, and utilized data provided by the organizations.
There was a profound disruption in the delivery of elective healthcare due to the COVID-19 pandemic, as procedures were canceled in order to boost health system capacity. As a consequence, the availability of testing and treatment for sleep disordered breathing, as well as other procedures unrelated to COVID-19, was likely impacted. Furthermore, the airborne nature of COVID-19 increased the danger of in-lab testing for sleep disordered breathing. Thus, the purpose of our study was to characterize how the pandemic impacted the assessment of sleep disordered breathing, as well as the associated impact of the pandemic on the use of health services related to sleep apnea.
The study analyzed claims for sleep testing occurring in 2019 and 2020, pertaining to people with health plans from a national healthcare organization. The patients receiving the care were adults with commercial and Medicare Advantage health plans. Year of testing (2019 versus 2020) served as the independent variable. Use of home-based testing, sleep disordered breathing treatment within 60 days of testing, and presence of a clinical visit related to sleep apnea within 60 days of testing were the outcomes examined. Chi-square tests were used for unadjusted analyses, and logistic regressions were used for adjusted analyses. The control variables included were the patient’s age, urbanicity, median income of ZIP code, region, sex, health plan line of business, procedure code of the patient’s initial sleep test, and month of testing.
The dataset consisted of 103,270 individuals that received sleep testing, with 46.5% receiving testing in 2020 and 53.5% receiving testing in 2019. Patients receiving sleep testing in 2020 were significantly (P<0.001) more likely to receive home-based testing (51.0% versus 40.5%), and were significantly (P<0.001) more likely to be treated following testing (37.3% versus 35.3%). There was no association (P=0.804) between year of testing and likelihood of having a clinical visit related to sleep apnea in the 60 days following testing. Adjusted analysis found that patients receiving sleep testing in 2020 had increased odds of treatment (OR: 1.029; 95% CI: 1.023-1.035). Testing in 2020 was not associated with significantly different adjusted odds (OR: 1.000; 95% CI: 0.998-1.002) of having a clinical visit related to sleep apnea in the 60 days following testing.
In response to the study’s findings, the study’s lead author, Adam C. Powell, Ph.D., remarked, “While home-based sleep testing has been available for many years, these findings suggest that the COVID-19 pandemic coincided with an uptick in its utilization. Several studies have shown that COVID-19 had implications across the healthcare system, and this study is yet another demonstration of how non-COVID care was impacted.”
To learn more about AcademyHealth: Dissemination & Implementation, visit: https://academyhealth.org/events/site/15th-annual-conference-science-dissemination-and-implementation-health