medigraphic.com
Anales de Otorrinolaringología Mexicana

2024, Number 3

<< Back Next >>

Otorrinolaringología 2024; 69 (3)

Cost minimization analysis of the supply of positive air pressure devices for the treatment of sleep apnea

Serrano SL, Mancilla MFJ, Méndez SLM, Martínez NJS, Sansores MDN, Orbelin MY, Pérez GR

Language: Spanish
References: 34
Page: 146-157
PDF size: 173.72 Kb.


ABSTRACT

Objective: To compare costs of positive air pressure device supply modalities (leasing vs purchase) to determine which implies a minimization of expense.
Materials and Methods: Operational, quantitative, descriptive, observational and prospective study. All eligible patients over 18 years of age were included, obtained from the database of a sleep clinic at a tertiary care hospital in Mexico City, with a diagnosis of obstructive sleep apnea-hypopnea syndrome in its different degrees of severity and under treatment with positive air pressure devices, from March 1st to June 30, 2022. Direct and indirect costs were considered using the micro-cost method, contemplating all the components of resource use, uncertainty, assumptions with long-term projection, including adjustment and incremental analysis according to the temporal differential, scenarios and assumptions for each modality.
Results: Two hundred seventy-nine patients were included. The estimate of care costs under the leasing scheme was 5.35 times higher compared to the 10-year purchase modality.
Conclusions: The results reinforce the position that the purchase alternative minimizes costs, and should be considered the most convenient choice in the hospital center where it was developed.


REFERENCES

  1. Acuerdo mediante el cual se expide el Manual de Percepciones de los Servidores Públicos de las Dependencias yEntidades de la Administración Pública Federal. (31 de mayo, 2022). Secretaría de Hacienda y Crédito Público.

  2. Adelaide A, Gigante AR, Machado D, Sanches I, et al. Transition from APAP to CPAP may be a cost-effectivehealth intervention in OSA patients. J Bras Pneumol 2021; 47 (06). doi: 10.36416/1806-3756/e20210286

  3. Arnaud C, Bochaton T, Pépina JL, Belaidi E. Obstructive sleep apnoea and cardiovascular consequences:Pathophysiological mechanisms. Arch Cardiovasc Dis 2020; 113: 350-58. doi: 10.1016/j.acvd.2020.01.003

  4. Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, et al. Estimation of the global prevalence and burden ofobstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 2019; 7-8: 687-98. doi: 10.1016/S2213-2600(19)30198-5

  5. Billings ME, Kapur VK. Medicare long-term CPAP coverage policy: A cost-utility analysis. J Clin Sleep Med2013; 9 (10): 1023-1029. doi: 10.5664/jcsm.3074

  6. Calculadora de variaciones del INPC sitio web (https://www.inegi.org.mx/app/indicesdeprecios/Estructura.aspx?idEstructura=112001300020&T=%C3%8Dndices%20de%20Precios%20al%20Consumidor&ST=Principales%20%C3%ADndices%20(mensual)

  7. Carro PR, González GD (s.f.). Diseño y medición de puestos de trabajo: Administración de las operaciones.4ª ed. Ediciones AO.

  8. Chang H, Chen Y, Du J. Obstructive sleep apnea treatment in adults. The Kaohsiung J Med Sci 2020; 36(1):7-12. doi: 10.1002/kjm2.12130

  9. Charles L, Triscott J, Dobbs B. Secondary hypertension: Discovering the underlying cause. Am Acad FamPhys 2017; 96 (7): 453-461.

  10. Cowie MR. Sleep apnea: State of the art. Trends Cardiovasc Med 2017; 27 (4): 280-289. doi: 10.1016/j.tcm.2016.12.00

  11. Drummont MF, O’Brien MJ, Stoddart GL, Torrance GW. Métodos para la evaluación económica de los programasde asistencia sanitaria. 2ª ed. Ediciones Díaz de Santos, 2002; 7-51.

  12. Encuesta sobre las Expectativas de los Especialistas en Economía del Sector Privado (diciembre, 2021),Banco de México.

  13. Fietze I, Laharnar N, Obst A, Ewert R, et al. Prevalence and association analysis of obstructive sleep apneawith gender and age differences – Results of SHIP-Trend. J Sleep Res 2018; e12770. doi: 10.1111/jsr.12770

  14. Floras JS. Sleep apnea and cardiovascular disease an enigmatic risk factor. Circ Res 2018; 122: 1741-1764.doi: 10.1016/j.tcm.2016.12.005

  15. Foldvary S, Waters TE. Sleep-disordered breathing. Continuum (Minneap Minn) 2017; 23 (4): 1093-1116.doi: 10.1212/01.CON.0000522245.13784.f6

  16. Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea. JAMA 2020; 323 (14):1389. doi:10.1001/jama.2020.3514

  17. Guía para la Evaluación Económica de Dispositivos Médicos. Secretaría de Salud, Centro Nacional de ExcelenciaTecnológica en Salud. 2017.

  18. Gulotta G, Iannella G, Vicini C, Polimeni A, et al. Risk factors for obstructive sleep apnea syndrome inchildren: State of the art. Int J Environ Res Public Health 2019; 16 (18): 3235. doi: 10.3390/ijerph16183235

  19. Higgins AM, Harris AH. Health economic methods: Cost-minimization, cost-effectiveness, cost-utility, andcost-benefit evaluations. Crit Care Clin 2012; 28 (1): 11-24. doi: 10.1016/j.ccc.2011.10.002

  20. Jafari B, Mohsenin V. Polysomnography. Clin Chest Med 2010; 31 (2): 287-297. doi: 10.1016/j.ccm.2010.02.005

  21. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, et al. Clinical Practice Guideline for Diagnostic Testingfor Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. JClin Sleep Med 2017; 13 (03): 479-504. https://doi.org/10.5664/jcsm.6506

  22. Maniaci A, Iannella G, Cocuzza S, Vicini C, et al. Oxidative stress and inflammation biomarker expressionin obstructive sleep apnea patients. J Clin Med 2021; 20: 277. doi: 10.3390/jcm10020277

  23. Masa JF, Mokhlesi B, Benítez I, Gómez de Terreros FJ, et al. Cost-effectiveness of positive airway pressuremodalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea. Thorax 2020; 0: 1-9.doi: 10.1136/thoraxjnl-2019-213622

  24. Norma de Información Financiera B1 Cambios contables y correcciones de errores (Septiembre, 2005). ConsejoMexicano para la Investigación y Desarrollo de Normas de Información Financiera AC.

  25. OrrùG A, Storari M, Scano A, Piras V, et al. Obstructive sleep apnea, oxidative stress, inflammation andendothelial dysfunction an overview of predictive laboratory biomarkers. Eur Rev Med Pharm Sci 2020; 24:6939-6948. doi: 10.26355/eurrev_202006_21685

  26. Otsuka K, Fukunaga K, Wakako Y, Haraguchi M, et al. Factors associated with improvements in subjectivesymptoms of obstructive sleep apnea syndrome after continuous positive airway pressure therapy. SleepBreath 2020; 24 (2): 491-498. doi: 10.1007/s11325-019-01877-5

  27. Parámetros de Estimación de Vida Útil (15 de agosto, 2012). Consejo Nacional de Armonización Contable

  28. Patakaa A, Daskalopouloub E, Kalamarasa G, Fekete PK, Argyropoulou P. Evaluation of five differentquestionnaires for assessing sleep apnea syndrome in a sleep clinic. Sleep Med 2014; 15 (7): 776-781. doi:10.1016/j.sleep.2014.03.012

  29. Patel SR. Obstructive sleep apnea. Ann Int Med 2019; 171 (11): ITC81. doi: 10.7326/AITC201912030

  30. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, et al. Treatment of adult obstructive sleep apnea with positiveairway pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med2019; 15 (02): 335-343. doi: 10.5664/jcsm.7640

  31. Pimenta E, Calhoun DA, Oparil S. Sleep apnea, aldosterone, and resistant hypertension. Prog CardiovascDis 2009; 51 (5): 371-380. doi: 10.1016/j.pcad.2008.02.004

  32. Ralls F, Cutchen L. A contemporary review of obstructive sleep apnea. Curr Opin Pulmy Med 2019; 25 (6):578-593. doi: 10.1097/MCP.0000000000000623

  33. Vanek J, Prasko J, Genzor S, Ociskova M, et al. Obstructive sleep apnea, depression and cognitive impairment.Sleep Med 2020; 72: 50-58. doi: 10.1016/j.sleep.2020.03.017

  34. Vensel RJ. Obstructive sleep apnea basics. Cleve Clin J Med 2019; 86 (1-9): 2-9. doi: 10.3949/ccjm.86.s1.02




2020     |     www.medigraphic.com