0503 The Impact of Health Disparities on Access to Care for Obstructive Sleep Apnea Patients: A Retrospective Study

Introduction Health disparities among sleep medicine patients can further worsen sleep-related breathing disorders. Sex, race, and insurance were analyzed to find association with access to care in patients with obstructive sleep apnea (OSA). Methods Inclusion criteria resulted in 11,896 adults aged 18 years or older through the years of 2015-2019 with diagnosis of OSA, snoring, hypersomnia, sleep related hypoventilation, or central sleep apnea. Multiple logistic regression models were used to examine significant correlates of outcomes. Results About 56% female and 57% black patients had a revisitation within one year, while 52% male (51.8%) and 49% white patients did so. Patients with Medicaid insurance (59%) had a higher percentage of revisitation within one year than those with HMO/PPO/EPO insurance (51%, p <.0001). These factors remain significant in the multiple logistic regression model. The average gap between visits for Medicaid patients was 72 days whereas the gaps for HMO/PPO/EPO and Medicare patients were 82 and 88 days, respectively. The odds of having a shorter gap between visits were 20% higher among Medicaid patients (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.06 - 1.35), and 17% lower among Medicare patients (OR, 0.83, 95% CI, 0.73-0.94), when compared to the odds among HMO/PPO/EPO patients. No significant differences in the average gap between visits were observed across different sex and race groups. Conclusion Sex, race, and insurance type were significantly associated with repeated visits within one year of initial visit; insurance type was further found to be associated with a shorter gap between visits. Policy to promote access to OSA care shall address these disparities. Ethnicity, age, and surgical procedure data will be additionally analyzed. Support (if any)