Table 3.
Racial and ethnic differences in the 1-year OSA treatment pathways among Medicaid patients (n=18,699)
| Percentage of patients on each treatment pathway | Odds ratio (95% CI) for likelihood of each treatment pathway in (ref: White) | ||||||
|---|---|---|---|---|---|---|---|
| White | Black | Hispanic/Latinx | Other | Black | Hispanic/Latinx | Other | |
| (1) Surgical care + PSG | 11.0% | 12.6% | 11.9% | 11.9% | 1.15 (1.05, 1.27) | 1.05 (.89, 1.25) | 1.08 (.82, 1.4) |
| (2) Surgical care only | 36.0% | 28.1% | 33.6% | 32.5% | .69 (.64, .74) | .94 (.84, 1.06) | 0.83 (.68, 1.00) |
| (3) PSG + specialty care | 3.6% | 5.5% | 5.5% | 5.6% | 1.60 (1.38, 1.86) | 1.55 (1.21, 1.98) | 1.64 (1.12, 2.41) |
| (4) PSG only | 6.5% | 8.6% | 8.4% | 5.2% | 1.36 (1.21, 1.53) | 1.30 (1.07, 1.59) | .82 (.55, 1.21) |
| (5) Specialty care only | 3.9% | 5.1% | 8.0% | 5.2% | 1.33 (1.15, 1.55) | 2.20 (1.78, 2.72) | 1.34 (.90, 1.99) |
| (6) PAP care | 3.1% | 3.2% | 2.3% | 2.6% | .98 (.81, 1.18) | .65 (.45, .93) | .88 (.50, 1.54) |
| (7) No care | 35.9% | 36.9% | 30.3% | 37.0% | 1.05 (.98, 1.12) | .77 (.68, .87) | 1.07 (.89, 1.28) |
| (8) Comprehensive care | -- | -- | -- | -- | -- | -- | -- |
Note. PAP=positive airway pressure; PSG=polysomnography. +Seven binomial logistic regression models after adjusting for child gender, age, any CCCs and obesity during 1-year prior to and at time of OSA diagnosis. Bold indicates significant associations (p<0.05).
PSG + surgical care: Any PSG prior to, at the time of, or post-OSA diagnosis plus surgical care (adenotonsillectomy, tonsillectomy, adenoidectomy).
Surgical care only: Surgical care without any PSG history.
PSG + specialty care: Any PSG prior to, at the time of, or post-OSA diagnosis plus pulmonary and/or otolaryngology visits.
PSG only: Any PSG prior to, at the time of, or post-OSA diagnosis with no surgical care, no PAP, and no specialty care.
Specialty care only: Pulmonary and/or otolaryngology visits only with no PSG, no surgical care, and no PAP.
PAP care: PAP prescription and/or PSG with PAP titration.
No treatment: No PSG history, surgical care, specialty care, or PAP care.
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).