Changes in Prescription Patterns and Diagnostic Outcomes of Polysomnography After Insurance Coverage: A Multicenter Retrospective Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: In June 2018, South Korea expanded insurance coverage for polysomnography (PSG) to improve diagnostic access for obstructive sleep apnea (OSA). This study investigated the impact of this policy by analyzing changes in PSG utilization and diagnostic outcomes. METHODS: A multicenter retrospective study was conducted using data from 17 tertiary hospitals across South Korea. Patients aged ≥20 years who visited the hospitals for suspected OSA between 2015 and 2023 were included. The pre-coverage period was defined as 2015-2017, and the post-coverage period as 2019-2023. Demographics, PSG implementation rates, and apnea-hypopnea index (AHI) distributions were compared. RESULTS: A total of 29,055 patients were included (7,800 pre-coverage; 21,255 post-coverage). PSG utilization significantly increased from 51.3% to 74.4% (p<0.001). The proportion of female patients rose from 20.0% to 23.0%, and the mean age increased from 45.8 to 49.8 years (p<0.001). The average AHI increased from 31.2 to 35.3. The proportion of patients with severe OSA (AHI ≥30) rose from 42.8% to 48.8%, while cases with normal AHI (<5) declined from 11.6% to 8.3% (p<0.001). CONCLUSION: The expansion of insurance coverage significantly improved PSG accessibility, particularly for older adults, women, and high-risk patients. The observed shift toward more severe diagnoses suggests enhanced detection of untreated OSA rather than overdiagnosis of mild or normal cases. These findings support the ongoing implementation of inclusive health policies while emphasizing the importance of appropriate patient selection.
Source: Journal of rhinology
Authors: Do-Yang Park, Jae Hoon Cho, Chan-Soon Park, Tae Kyung Koh, Soo Kweon Koo, Sang-Wook Kim, Su Jin Kim, Yong Min Kim, Jeong-Whun Kim, Jin Youp Kim, Hyun Jun Kim, Jeon Gang Doo, Jee Won Moon, Marn Joon Park, Seok-Won Park, Song I Park, Sookyoung Park, Mi Rye Bae, Min Young Seo, Sang Hyeon Ahn, Hyung Chae Yang, Kun Hee Lee, Seung Hoon Lee, Young-Ha Lee, Eun Jung Lee, Young Joon Jun, Yung Jin Jeon, Yoo-Sam Chung, Jaein Chung, Kyu-Sup Cho, Sung-Woo Cho, Yong Seok Jo, Hee Sung Chae, Ick Soo Choi, Ji Ho Choi, Seung Cheol Han
Institutions: Ajou University, Konkuk University, Konkuk University Medical Center, The Catholic University of Korea St. Vincent's Hospital, Catholic University of Korea, Gyeongsang National University, Kyung Hee University, Gyeongsang National University Hospital, Kyung Hee University Hospital at Gangdong, Chungnam National University, Seoul National University, Dongguk University, Seoul National University Bundang Hospital, Dongguk University Ilsan Hospital, Eulji University, Eulji University Nowon Eulji Medical Center, Korea University Guro Hospital, Inha University, Inha University Hospital, Inje University Ilsan Paik Hospital, Chungnam National University Sejong Hospital, Bundang Jesaeng Hospital, Korea University Ansan Hospital, Chonnam National University, Chonnam National University Hospital, Yonsei University, Eulji University Uijeongbu Eulji Medical Center, Asan Medical Center, University of Ulsan, Pusan National University Hospital, Pusan National University, Soonchunhyang University, Soonchunhyang University Hospital Bucheon
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $50
OpenAlex ID: W4416776902
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