Health care use predicts apnea diagnosis in kids

NEW YORK (Reuters Health) - Starting in the first year of life, children ultimately diagnosed with obstructive sleep apnea syndrome have significantly more health care use than unaffected children, according to findings published in the American Journal of Respiratory and Critical Care Medicine.

The use of health care, a reliable measure of illness, is noticeably higher 1 year before the diagnosis of obstructive sleep apnea syndrome (OSAS) in preschool children, Dr. Ariel Tarasiuk and colleagues from Ben-Gurion University of the Negev, Beer-Sheva, Israel, report.

The researchers examined the extent of illness and health care use among children with OSAS starting in the first year of life to the date of diagnosis. Included in the study were 156 patients (ages 3 to 5 years) and 156 healthy children matched to the patients.

Tests revealed an average of 8.1 apnea events per hour in the children with OSAS. The computerized databases of Clalit Health Care Services, the largest HMO in Israel, were used to obtain factors associated with health care use.

Children with OSAS had 40 percent more hospital visits and 20 percent more repeated visits from the first year of life to the date of OSAS diagnosis, the investigators found.

Children with OSAS also used more respiratory infection drugs and referrals to otolaryngology surgeons and pediatric pulmonologists were more frequent from the first year of life to date of diagnosis. This was especially true in year 4.

"Annual health care use among the OSAS group was $275 compared with $128 in the control group -- that is, 215 percent higher compared with the control group," Tarasiuk and colleagues calculate. This elevation in health care use was due mainly to a higher occurrence of respiratory tract illness.

"Practitioners should be aware," the investigators conclude, "that starting in year 1 until date of diagnosis, children with OSAS have higher health care use, mostly related to respiratory disease." The findings suggest the need for "early diagnosis and intervention in children with OSAS."

SOURCE: American Journal of Respiratory and Critical Care Medicine, January 2007.