Obstructive Sleep Apnea Surgery Practice Patterns in the United States: 2019.

Abstract

Objective: This study aims to determine the volumes and facility costs/charges for procedures used to treat the pharyngeal airway in adults with obstructive sleep apnea (OSA) in the United States in 2019, and to explore whether specific patient and facility characteristics are associated with procedure type and costs/charges.

Study design: A cross-sectional study.

Setting: Nationwide databases (National Inpatient Sample and the Nationwide Ambulatory Surgery Sample).

Methods: OSA procedures were identified in both inpatient and outpatient settings using both databases. Chi-squared tests and regression analyses examined procedure volume, type, and facility costs/charges, with adjustments made for specific patient and facility characteristics.

Results: In 2019, an estimated 18,526 discharges/encounters involving OSA surgery were performed in inpatient and outpatient settings. These included 12,938 palate surgeries, 1350 hypopharyngeal surgeries, 3054 unilateral hypoglossal nerve stimulation (HNS) system implantations, and 1840 maxillomandibular advancement procedures. The odds of undergoing HNS, as compared to almost all other categories of procedures, were generally greater for those aged 40 years or older (compared to younger patients) but generally lower for almost all non-white groups compared to white patients. Younger patients were more likely to undergo isolated palate surgery, compared to other surgical procedure types. Facility costs (inpatient) and charges (outpatient) were greater for HNS than other procedure types, and there were differences variably associated with patient and facility characteristics.

Conclusion: Surgical treatment is performed in approximately 0.03% to 0.77% of all adults in the United States with OSA annually. Specific factors are associated with procedure type and facility costs/charges.