Implementation of a new healthcare model for Obstructive Sleep Apnea diagnosis by a family doctor using a simplified device(ApneaLinkTM®) in conjunction with the hospital sleep unit and cost study

<bold>Aim:</bold> To implement a new healthcare model(NCM) for Obstructive Sleep Apnea(OSA) diagnosis(DS) integrating family doctors(FD) into Hospital Sleep Unit(HSU) and study direct cost. <bold>Method:</bold> prospective study. FD recruited patients(P) with clinical suspicion of OSA;and completed clinic, physical examination and STOP-Bang(SB) survey. Cases with SB≥3, did sleep study with APNEALINKTM®(AL).FD checked AL test, proposed a DS and treatment(TT), that must be confirmated by HSU. If test wasn’t congruent, USH completed exam with PGR or PSG(NCM). If SB<3,they completed study according current care model(CCM), by HSU with PGR.FD diagnosed OSA if AHI≥5, and ordered CPAP if AHI≥15 and symptoms/comorbidities were presents. Demographic, anthropometric, clinical variables, test results, delay and direct cost(staff, material, maintenance, displacement and monitoring)were collected. AL result were checked by FD,their DS and TT findings were compared with HSU’s decisions. NCM’s delay and costs were calculated and compared with CCM data. Statistical studies were obtained by SPSS. Results:148P were included.144P had SB≥3 and followed NCM;133P(92%) shown AHI≥5, and 98P(74%) had AHI≥15(94% DS efficacy);88P(66%) needed CPAP. 4P had SB<3 and followed CCM. It showed 92% congruence between FD and HSU's DS decisions, and 90% between TT;saving €1.878,3.NCM shortened the delay compared to CCR. Conclusions:SB is a good OSA screening tool for FD. NCM is a cheaper model that can be applied by FD in conjunction with HSU for a better OSA approach. Study must be expanded to improve results.(ERJ.2019;54:Suppl.63,PA4001/AJRCCM.2018;198(5):648-56)