Table 2.

Differences in the 1-year OSA treatment pathways by insurance provider (n=31,585)

	Percentage of patients on each treatment pathway			Odds ratio for likelihood of each treatment pathway in Medicaid patients (ref: Commercial)+
	All	Commercial	Medicaid	OR	95% CI
(1) Surgical care + PSG	11.4%	11.3%	11.7%	1.02	.95, 1.09
(2) Surgical care only	31.8%	30.6%	32.9%	1.21	1.15, 1.28
(3) PSG + specialty care	5.9%	8.0%	4.5%	.52	.47, 57
(4) PSG only	6.4%	5.0%	7.3%	1.46	1.32, 1.61
(5) Specialty care only	6.1%	8.1%	4.7%	.57	.52, .63
(6) PAP care	3.4%	4.0%	3.1%	.68	.59, .77
(7) No care	34.4%	33.0%	35.8%	1.13	1.07, 1.18
(8) Comprehensive care	0.6%	--	--	--	--

PAP=positive airway pressure; PSG=polysomnography.

⁺Binomial logistic regression models after adjusting for child gender, age, any complex chronic conditions, and obesity during 1-year prior to and at time of OSA diagnosis. Bold indicates significant associations (p<0.05).

⁽¹⁾PSG + surgical care: Any PSG prior to, at the time of, or post-OSA diagnosis plus surgical care (adenotonsillectomy, tonsillectomy, adenoidectomy).

⁽²⁾Surgical care only: Surgical care without any PSG history.

⁽³⁾PSG + specialty care: Any PSG prior to, at the time of, or post-OSA diagnosis plus pulmonary and/or otolaryngology visits.

⁽⁴⁾PSG only: Any PSG prior to, at the time of, or post-OSA diagnosis with no surgical care, no PAP, and no specialty care.

⁽⁵⁾Specialty care only: Pulmonary and/or otolaryngology visits only with no PSG, no surgical care, and no PAP.

⁽⁶⁾PAP care: PAP prescription and/or PSG with PAP titration.

⁽⁷⁾No treatment: No PSG history, surgical care, specialty care, or PAP care.

⁽⁸⁾Comprehensive care: Excluded due to small sample size (n=202) and high utilization of OSA-related care (i.e., surgical care, PAP, and/or PSG, and/or specialty care).