Survey on health care resources for diagnostic and therapeutic OSA management from Italian region Emilia-Romagna [Censimento delle strutture e delle risorse impegnate in Emilia-Romagna nella diagnosi e terapia dell'OSA]

Background. It is estimated that in Italy more than 2 million people are affected by a moderate to severe form of obstructive sleep apnea syndrome (OSA). In the Italian region Emilia-Romagna, OSA patients are expected to be over 110,000. Aim and methods. To evaluate the amount of OSA patients diagnosed and treated every year by the regional health service and the standards of clinical and instrumental management, a questionnaire was submitted to the centers operating in Emilia-Romagna on sleep disordered breathing. The questionnaire was endorsed by AIPO (Italian Association of Hospital Pulmunologists), AIMS (Italian Association of Sleep Medicine), AOOI (Italian Association of Hospital ENT). A total of 19 clinical units answered the questionnaire. Results. Patients/year with a diagnosis of OSA were 3,000, 4,000 examinations/year were carried out by 39 doctors who dedicated to OSA an average of 31% of their working time. Sleep centers followed the most important indications of guidelines for the diagnosis and management of OSA. 83% of sleep centers guaranteed a first-visit within 6 months, 24% were able to provide it within 30 days. Diagnostic investigation occurred within 3 months after the first visit in 41% of the centers, in 29% the interval could last 1 year. In more than 50% of the centers, CPAP titrations were accomplished within 30 days following the diagnostic exam. However, the waiting list was longer than 6 months in 24% of the centers. An active follow-up was provided by 59% of the centers, and 41% regularly monitored the CPAP memory card. Conclusions. Besides the split between potential (110,000) and diagnosed (3,000/year) OSA patients, the survey also indicates that the health professionals, though fulfilling guidelines, cannot carry out the entire procedures from diagnosis to follow-up. Additional energies and a stronger coordination in the framework of a regional health network are deemed necessary to allow the existing sleep centers to operate effectively.