Sleep Breath 2004; 8(4): 185-192
DOI: 10.1055/s-2004-860895
ORIGINAL ARTICLE

Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Disparities in Obstructive Sleep Apnea and Its Management between a Minority-Serving Institution and a Voluntary Hospital

Harly Greenberg1 , Jean Fleischman2 , Hossam E. Gouda1 , Angel E. De La Cruz1 , Ricardo Lopez2 , Karen Mrejen2 , Anna Web2 , Steven Feinsilver1
  • 1North Shore-Long Island Jewish Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Long Island Jewish Medical Center and North Shore University Hospital, New Hyde Park, New York
  • 2Division of Pulmonary and Critical Care Medicine, Mount Sinai Services at Queens Hospital Center, Jamaica, New York
Further Information

Publication History

Publication Date:
20 December 2004 (online)

ABSTRACT

We assessed disparities in severity of obstructive sleep apnea (OSA) and associated comorbidities, as well as in provision of sleep medicine health care, between patients evaluated for OSA in a voluntary hospital (VH) primarily serving a middle-class population with health-care insurance and a city hospital-based minority-serving institution (MSI) largely treating lower income, uninsured, and indigent patients. A retrospective chart review of patients evaluated for OSA at the VH (n = 200) and at the MSI (n = 103) was performed. Despite similar age and apnea hypopnea index, MSI patients had a greater body mass index, higher daytime systemic blood pressure, more comorbid medical conditions, and a lower minimum sleep SaO2 than VH patients. Systemic hypertension, diabetes mellitus, asthma, and congestive heart failure were more prevalent in the MSI group. Forty-two percent of the MSI patients diagnosed with OSA failed to follow up for treatment compared with 7% in the VH group, p < 0.001. Disparities in OSA-associated comorbid conditions, as well as in delivery of sleep medicine-related health care, were evident between the VH and MSI groups. These findings suggest that OSA may be an important factor contributing to socioeconomic-based differences in morbidity and mortality.

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Harly GreenbergM.D. 

Division of Pulmonary and Critical Care Medicine, Long Island Jewish Medical Center

New Hyde Park

NY 11040

Email: greenber@lij.edu