A multicenter prospective comparative effectiveness study of the effect of physician certification and center accreditation on patient-centered outcomes in obstructive sleep apnea

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Abstract

Objectives: To study the effect of sleep center accreditation and Sleep Medicine board certification of physicians on patient-centered outcomes in obstructive sleep apnea (OSA). Design: Prospective, multicenter, comparative effectiveness study. Setting: Four sleep centers Patients: 502 patients with OSA. Interventions: None. Measurements and Results: Patients at two accredited and two non-accredited centers underwent polysomnography at participating locations and completed validated questionnaires, with objective measurement of positive airway pressure (PAP) therapy adherence performed three months after therapy initiation. The proportion of patients (age 53 ± 13[SD] years; 26% women; and body mass index 33.6 ± 7.2 kg/m2) who were adherent to PAP therapy by Medicare guidelines (> 70% of nights with ≥ 4 h use over a 30-day period) was greater in accredited (79%) than non-accredited sites (64%; p = 0.004). After adjustment for confounding variables, patients who received care from accredited centers (odds ratio [OR] 2.2, 95% confidence interval [CI], 1.2-4.2; p = 0.016) and certified physicians (OR 2.3, 95% CI, 1.3-4.0; p = 0.005) were more likely to be adherent to PAP therapy than those who received care from non-accredited centers and non-certified physicians. Patient satisfaction was associated with greater education received from physician (OR 4.6; 95% CI 2.3-9.3); greater risk perception (OR 2.7; 95% CI 1.0-7.4); physician certification (OR 2.1; 95% CI 1.1-4.2); and inversely related to delays in care (OR 0.5; 95% CI 0.3-0.9; p < 0.05). Such delays were inversely related to accreditation-certification status (p < 0.0001). Conclusions: In patients with OSA, accreditation-certification status of sleep centers and physicians was associated with better PAP adherence, better patient education, better patient satisfaction, and greater timeliness.

Original languageEnglish (US)
Pages (from-to)243-249
Number of pages7
JournalJournal of Clinical Sleep Medicine
Volume10
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Accreditation
Certification
Obstructive Sleep Apnea
Physicians
Odds Ratio
Confidence Intervals
Sleep
Pressure
Patient Education
Patient Satisfaction
Confounding Factors (Epidemiology)
Polysomnography
Therapeutics
Medicare
Body Mass Index
Medicine
Guidelines
Education

Keywords

  • Continuous positive airway pressure
  • Obstructive sleep apnea
  • Patient satisfaction
  • Professional competence
  • Sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology
  • Medicine(all)

Cite this

@article{d47c8ac6249a4ef582a6b18da87a3306,
title = "A multicenter prospective comparative effectiveness study of the effect of physician certification and center accreditation on patient-centered outcomes in obstructive sleep apnea",
abstract = "Objectives: To study the effect of sleep center accreditation and Sleep Medicine board certification of physicians on patient-centered outcomes in obstructive sleep apnea (OSA). Design: Prospective, multicenter, comparative effectiveness study. Setting: Four sleep centers Patients: 502 patients with OSA. Interventions: None. Measurements and Results: Patients at two accredited and two non-accredited centers underwent polysomnography at participating locations and completed validated questionnaires, with objective measurement of positive airway pressure (PAP) therapy adherence performed three months after therapy initiation. The proportion of patients (age 53 ± 13[SD] years; 26{\%} women; and body mass index 33.6 ± 7.2 kg/m2) who were adherent to PAP therapy by Medicare guidelines (> 70{\%} of nights with ≥ 4 h use over a 30-day period) was greater in accredited (79{\%}) than non-accredited sites (64{\%}; p = 0.004). After adjustment for confounding variables, patients who received care from accredited centers (odds ratio [OR] 2.2, 95{\%} confidence interval [CI], 1.2-4.2; p = 0.016) and certified physicians (OR 2.3, 95{\%} CI, 1.3-4.0; p = 0.005) were more likely to be adherent to PAP therapy than those who received care from non-accredited centers and non-certified physicians. Patient satisfaction was associated with greater education received from physician (OR 4.6; 95{\%} CI 2.3-9.3); greater risk perception (OR 2.7; 95{\%} CI 1.0-7.4); physician certification (OR 2.1; 95{\%} CI 1.1-4.2); and inversely related to delays in care (OR 0.5; 95{\%} CI 0.3-0.9; p < 0.05). Such delays were inversely related to accreditation-certification status (p < 0.0001). Conclusions: In patients with OSA, accreditation-certification status of sleep centers and physicians was associated with better PAP adherence, better patient education, better patient satisfaction, and greater timeliness.",
keywords = "Continuous positive airway pressure, Obstructive sleep apnea, Patient satisfaction, Professional competence, Sleep",
author = "Sairam Parthasarathy and Shyam Subramanian and Quan, {Stuart F}",
year = "2014",
doi = "10.5664/jcsm.3518",
language = "English (US)",
volume = "10",
pages = "243--249",
journal = "Journal of Clinical Sleep Medicine",
issn = "1550-9389",
publisher = "American Academy of Sleep Medicine",
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T1 - A multicenter prospective comparative effectiveness study of the effect of physician certification and center accreditation on patient-centered outcomes in obstructive sleep apnea

AU - Parthasarathy, Sairam

AU - Subramanian, Shyam

AU - Quan, Stuart F

PY - 2014

Y1 - 2014

N2 - Objectives: To study the effect of sleep center accreditation and Sleep Medicine board certification of physicians on patient-centered outcomes in obstructive sleep apnea (OSA). Design: Prospective, multicenter, comparative effectiveness study. Setting: Four sleep centers Patients: 502 patients with OSA. Interventions: None. Measurements and Results: Patients at two accredited and two non-accredited centers underwent polysomnography at participating locations and completed validated questionnaires, with objective measurement of positive airway pressure (PAP) therapy adherence performed three months after therapy initiation. The proportion of patients (age 53 ± 13[SD] years; 26% women; and body mass index 33.6 ± 7.2 kg/m2) who were adherent to PAP therapy by Medicare guidelines (> 70% of nights with ≥ 4 h use over a 30-day period) was greater in accredited (79%) than non-accredited sites (64%; p = 0.004). After adjustment for confounding variables, patients who received care from accredited centers (odds ratio [OR] 2.2, 95% confidence interval [CI], 1.2-4.2; p = 0.016) and certified physicians (OR 2.3, 95% CI, 1.3-4.0; p = 0.005) were more likely to be adherent to PAP therapy than those who received care from non-accredited centers and non-certified physicians. Patient satisfaction was associated with greater education received from physician (OR 4.6; 95% CI 2.3-9.3); greater risk perception (OR 2.7; 95% CI 1.0-7.4); physician certification (OR 2.1; 95% CI 1.1-4.2); and inversely related to delays in care (OR 0.5; 95% CI 0.3-0.9; p < 0.05). Such delays were inversely related to accreditation-certification status (p < 0.0001). Conclusions: In patients with OSA, accreditation-certification status of sleep centers and physicians was associated with better PAP adherence, better patient education, better patient satisfaction, and greater timeliness.

AB - Objectives: To study the effect of sleep center accreditation and Sleep Medicine board certification of physicians on patient-centered outcomes in obstructive sleep apnea (OSA). Design: Prospective, multicenter, comparative effectiveness study. Setting: Four sleep centers Patients: 502 patients with OSA. Interventions: None. Measurements and Results: Patients at two accredited and two non-accredited centers underwent polysomnography at participating locations and completed validated questionnaires, with objective measurement of positive airway pressure (PAP) therapy adherence performed three months after therapy initiation. The proportion of patients (age 53 ± 13[SD] years; 26% women; and body mass index 33.6 ± 7.2 kg/m2) who were adherent to PAP therapy by Medicare guidelines (> 70% of nights with ≥ 4 h use over a 30-day period) was greater in accredited (79%) than non-accredited sites (64%; p = 0.004). After adjustment for confounding variables, patients who received care from accredited centers (odds ratio [OR] 2.2, 95% confidence interval [CI], 1.2-4.2; p = 0.016) and certified physicians (OR 2.3, 95% CI, 1.3-4.0; p = 0.005) were more likely to be adherent to PAP therapy than those who received care from non-accredited centers and non-certified physicians. Patient satisfaction was associated with greater education received from physician (OR 4.6; 95% CI 2.3-9.3); greater risk perception (OR 2.7; 95% CI 1.0-7.4); physician certification (OR 2.1; 95% CI 1.1-4.2); and inversely related to delays in care (OR 0.5; 95% CI 0.3-0.9; p < 0.05). Such delays were inversely related to accreditation-certification status (p < 0.0001). Conclusions: In patients with OSA, accreditation-certification status of sleep centers and physicians was associated with better PAP adherence, better patient education, better patient satisfaction, and greater timeliness.

KW - Continuous positive airway pressure

KW - Obstructive sleep apnea

KW - Patient satisfaction

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