Details

Autor(en) / Beteiligte

• Ensrud, Kristine E
• Kats, Allyson M
• Schousboe, John T
• Langsetmo, Lisa
• Taylor, Brent C
• Ancoli-Israel, Sonia
• Stone, Katie L

Titel

0713 Sleep Health and Healthcare Costs and Utilization in Older Women

Ist Teil von

• Sleep (New York, N.Y.), 2019-04, Vol.42 (Supplement_1), p.A286-A287

Ort / Verlag

Westchester: Oxford University Press

Erscheinungsjahr

2019

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Introduction Previous studies have suggested that specific sleep disorders (insomnia, sleep apnea) may be associated with higher utilization of healthcare services. We examined the association of an aggregate measure of sleep health dimensions with subsequent total healthcare costs and utilization. Methods We linked 1,468 community-dwelling women (mean age 83.7 years) participating in the Study of Osteoporotic Fractures Year 16 (Y16) examination (2002-2004) with their Medicare claims. An aggregate index (ranging from 0 to 5) was created from five dimensions of self-reported sleep health at Y16 including sleep satisfaction, daytime sleepiness, mid-sleep timing, sleep onset latency, and sleep duration. Total direct healthcare costs and utilization were ascertained during 36 months after Y16. Results Mean (SD) total annualized healthcare costs (2017 dollars) increased in a graded manner across the sleep health index ranging from $11,022 (16,276) among women with no sleep health impairment up to $15,672 (22,941) in women with impairment in 3-5 dimensions (p <0.004). After adjustment for age, race and site, women with impairment in 3-5 sleep health dimensions vs. those with no impairment had greater mean total costs (cost ratio (CR) 1.34, 95% CI 1.13-1.60) and higher odds of hospitalization (odds ratio (OR) 1.39, 95% CI 1.01-1.92). Of the individual dimensions, daytime sleepiness (CR 1.23, 95% CI 1.01-1.49) and short or long sleep duration (CR 1.20, 95% CI 1.07-1.35) were each associated with higher total health care costs. After further accounting for number of comorbid medical conditions, functional status and depressive symptoms, impairment in 3-5 sleep health dimensions was no longer related to total costs (CR 1.03, 95% CI 0.86-1.22) or hospitalization (OR 0.96, 95% CI 0.68-1.35). Multidimensional sleep health was not associated with outpatient costs or odds of a stay in a skilled nursing facility. Conclusion Older women with poor sleep health have higher subsequent total healthcare costs and an increased risk of hospitalization attributable to their greater burden of comorbid medical conditions, functional limitations and depressive symptoms. Support (If Any) Support was provided by Merck & Co. The Study of Osteoporotic Fractures was supported by NIH funding.