The risk of increased health care utilization among children with chronic conditions is higher among children who also have sleep problems, according to a new study examining Medicaid claims data.
This study found that among children with a chronic illness, those diagnosed with a sleep disorder were almost twice as likely to utilize health care (odds ratio = 1.83) compared to those without a sleep disorder. Ta. The most common sleep disorder diagnosis was sleep-disordered breathing, which was present in 1,796 children. Those with sleep-disordered breathing were 1.5 times more likely to have increased health care utilization (OR = 1.51). The researchers adjusted their analyzes to account for potential confounders such as age, race, and chronic medical conditions.
This result is impressive and suggests a clear role for sleep disturbances in healthcare utilization in children with chronic diseases. ”
Dr. Pranshu Adavadkar, Principal Investigator and First Author, Associate Professor of Pediatrics, University of Illinois at Chicago, Director of Pediatric Sleep Medicine, UI Health Sleep Sciences Center
The study results will be published in the April 1 issue of the Journal of Clinical Sleep Medicine, the official publication of the American Academy of Sleep Medicine.
Researchers extracted Illinois Medicaid claims data for 16,325 children up to age 18. The study population primarily resided in urban areas, and most of the participants represented ethnic minority groups with low socio-economic status. Each child had at least one chronic medical condition, such as asthma, obesity, diabetes, or attention-deficit/hyperactivity disorder, and 77% of the children had multiple chronic medical conditions. Participants were divided into their three levels of health care utilization based on their hospitalizations and emergency department visits in the 12 months prior to study enrollment. low (no hospitalizations or ED visits), moderate (1-2 hospitalizations or 1-3 ED visits), and high (3 or more hospitalizations or 4 or more ED visits).
Chronic medical conditions and sleep disorders were identified using International Classification of Diseases, Ninth Revision and ICD-10 codes. Sleep-disordered breathing – includes diagnoses of apnea alone, snoring alone, and apnea and snoring combined. It was found in 14.2% of children with medium utilization of health services and 20.6% of children with high utilization.
Adavadkar noted that children with chronic medical conditions have disproportionately higher health care utilization and costs and tend to have families with lower socioeconomic status. – including those covered by Medicaid insurance programs; tend to bear the brunt of these costs. Therefore, his one strategy to reduce these costs is to treat co-occurring sleep disorders.
“Understanding the specific sleep disorders that significantly increase the risk of health care utilization can inform targeted interventions and screenings to better manage these high-risk children.” said Adavadkar.
The authors noted that because sleep disorders tend to be underdiagnosed in pediatric populations, the association between sleep disorders and health care utilization may be even stronger than the results of this study suggest.
sauce:
American Academy of Sleep Medicine
Reference magazines:
Adavadkar, P.A., et al. (2024). Associations between sleep disturbances and health care utilization in children with chronic illnesses: A Medicaid claims data analysis. Journal of Clinical Sleep Medicine. doi.org/10.5664/jcsm.10936.
