Abstract

Introduction

Despite a growing literature regarding the impact of board-certification in sleep medicine, little is known about the complexity of patients seen by board-certified sleep medicine physicians (BCSMPs) relative to non-specialists. To address this gap, the purpose of the current study was to evaluate the differences in sleep complaints among Medicare beneficiaries seen by BCSMPs relative to individuals seen by non-specialists.

Methods

Our data source was a random 5% sample of Medicare administrative claims data from 2006-2013. Sleep disorders were operationalized using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Descriptive analyses were performed to estimate the number of sleep disorder diagnoses patients received by provider status. BCSMPs were identified using a cross-matching procedure based on National Provider Identifier (NPI).

Results

A total of 57,209 Medicare beneficiaries received a sleep disorder diagnosis between 2006-2013. Of these, only 2.2% were seen by BCSMPs. Relative to beneficiaries seen by non-specialists, those seen by BCSMPs were more likely to be diagnosed with more than one sleep disorder (p<0.001). Specifically, 91.0% of individuals seen by non-specialists received only one sleep disorder diagnosis, whereas 75.9% of individuals seen by BCSMPs received only one sleep disorder diagnosis. Among beneficiaries seen by non-specialists, the most common sleep disorders were insomnia (48.2%; n=26,967), obstructive sleep apnea (OSA; 31.4%; n=17,554), and restless legs syndrome (8.7%; n=4,871). Among those seen by BCSMPs, the most common sleep disorders were OSA, (70.4%; n=901), sleep apnea with hypersomnia (16.5%; n=211), and insomnia (11.7%; n=150).

Conclusion

BCSMPs see more complex sleep patients than do non-specialists. These results suggest the possibility that more complex patients are referred for sleep specialty care. Further, these results demonstrate the value of board certification in sleep medicine in caring for complex sleep patients.

Support

This research was supported by an AASM Strategic Research Award from the AASM Foundation to the University of Maryland, Baltimore (PI: EMW).

中文翻译：

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1183年获得委员会认证的睡眠医学医师比非专家提供更多的复杂睡眠患者

摘要

介绍

尽管有关董事会认证对睡眠医学的影响的文献越来越多，但对董事会认证的睡眠医学医师（BCSMP）相对于非专家所见患者的复杂性知之甚少。为了解决这一差距，本研究的目的是评估BCSMP所见的医疗保险受益人与非专科医生所见的个人在睡眠投诉方面的差异。

方法

我们的数据来源是2006-2013年医疗保险行政索赔数据的5％随机抽样。使用《国际疾病分类》，《第九修订版》和《临床修改规范》对睡眠障碍进行手术治疗。进行描述性分析以评估按提供者身份接受睡眠障碍诊断的患者数量。使用基于国家提供商标识符（NPI）的交叉匹配程序来识别BCSMP。

结果

在2006年至2013年之间，共有57,209名Medicare受益人接受了睡眠障碍诊断。其中，只有2.2％的BCSMP被发现。相对于非专业人士所见的受益人，BCSMP所见的受益人更有可能被诊断患有一种以上的睡眠障碍（p <0.001）。具体而言，非专业人员看到的个体中有91.0％仅接受一种睡眠障碍诊断，而BCSMP看到的个体中只有75.9％仅接受一种睡眠障碍诊断。在非专科医生的受益人中，最常见的睡眠障碍是失眠（48.2％； n = 26,967），阻塞性睡眠呼吸暂停（OSA; 31.4％; n = 17,554）和腿不安综合症（8.7％; n = 4,871） 。在由BCSMPs观察到的疾病中，最常见的睡眠障碍是OSA（70.4％； n = 901），伴有失眠的睡眠呼吸暂停（16.5％； n = 211）和失眠（11.7％； n = 150）。

结论

与非专科医生相比，BCSMP所见的睡眠患者更为复杂。这些结果表明，可能会将更复杂的患者转介到睡眠专科护理。此外，这些结果证明了睡眠医学委员会认证在照顾复杂睡眠患者方面的价值。

支持

这项研究得到了AASM基金会授予巴尔的摩马里兰大学的AASM战略研究奖的支持（PI：EMW）。