0527 Is Inpatient Polysomnography Associated with Limited Healthcare Access, and Economic and Social Deprivation?

Abstract Introduction In Alberta Canada care and funding models for sleep-disordered breathing (SDB) are fragmented, which may delay treatment particularly for socio-economically deprived individuals and contribute to the frequency and length of hospitalization. We assessed for economic and social deprivation as well as multimorbidity among adults undergoing diagnostic polysomnography (PSG) during hospitalization compared to age and sex-matched hospitalized and ambulatory controls. Methods In this retrospective health administrative data study, we included all individuals undergoing PSG during a hospitalization (SDB inpatients) from January 1, 2019, to December 31st, 2021, in a large, academic hospital-based sleep center in Calgary, Canada. We created time, age- and sex-matched control groups, each with a 2: 1 ratio: 1) individuals referred to the sleep center (non-acute control) ; 2) hospitalized individuals who did not undergo PSG (acute control). Clinical records were linked to health administrative databases of routinely collected health variables, using validated algorithms to define comorbidities, social and economic deprivation, marginalization, and rurality. Between-group differences were assessed for statistical significance using paired analysis with a significance level of 0. 05. Results We matched 275 individuals who underwent PSG during hospitalization with 550 acute and 550 non-acute controls. At baseline, SDB inpatients had greater health care utilization and a higher prevalence of comorbidities with a median IQR Charlson Comorbidity index of 3 2, 5 vs 1 0, 3 for acute controls and 1 0, 2 for non-acute controls. Compared to the acute controls, SDB inpatients did not have higher rates of social deprivation or median marginalization (3 2, 5 vs 3 2, 5) ; however, they were more likely to be receiving social assistance (24% vs 12 %) and live in urban areas (88% vs 76%). Compared to non-acute control, SDB inpatients had a higher median rate of marginalization (32, 5 vs 31, 4), lower median income (48925 38677, 61632 vs 55252 44745, 71310, and were more often receiving social assistance (24% vs. 14%). Conclusion SDB inpatients have a greater burden of multimorbidity and are more socially disadvantaged by several metrics. Follow-up studies are needed to determine if an earlier diagnosis could reduce the development of medical and social complications of untreated SDB. Support (if any)