Clinical and Financial Significance of Insomnia within a Large Payor-Provider Health System

Bradley E Karlin, Ryan J Anderson, Jillian M Rung, Charlotte Drury-Gworek, Tyson S Barrett
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Abstract

Insomnia has profound negative effects on behavioral health, physical health, and functional domains. Leveraging claims data from one of the nation’s largest payor-provider systems, the current study examined real-world prevalence of insomnia, comorbidity of insomnia with behavioral health and other sleep disorders, and the impact of insomnia on total health care costs. Prevalence and costs associated with insomnia were assessed by examining claims data on approximately 3 million insured members during the year 2022. Using propensity score matching, total health care expenditures were calculated and compared for members with insomnia relative to matched cohorts without insomnia. Generalized linear modeling tested for differences between the cohorts. Nine percent of members were identified as having insomnia; 64% of those also had a depression, anxiety, and/or substance use disorder. Median total health care costs among individuals with insomnia were 4-6 times greater than among those without insomnia. A disproportionate amount (21.1%) of total claims spend came from members with insomnia. Findings demonstrate a high degree of clinical need and behavioral health comorbidity associated with insomnia within a large insured cohort. Beyond the clinical significance, the current results demonstrate substantial financial need and opportunity for adequately treating insomnia. This is especially the case for the high proportion of members with insomnia and co-occurring depression, anxiety, and/or substance use disorders. Overall, the findings point to the important role payors and providers may have in promoting greater attention to sleep and insomnia.
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失眠症在大型支付方-提供方医疗系统中的临床和财务意义
失眠会对行为健康、身体健康和功能领域产生深远的负面影响。本研究利用美国最大的支付方-提供方系统之一的理赔数据,对失眠症的实际患病率、失眠症与行为健康和其他睡眠障碍的合并症,以及失眠症对医疗保健总成本的影响进行了研究。 通过研究 2022 年约 300 万名投保人的理赔数据,对失眠症的患病率和相关费用进行了评估。通过倾向得分匹配法,计算并比较了失眠症患者与无失眠症患者的医疗总支出。广义线性模型检验了组群之间的差异。 9%的成员被确认为患有失眠症;其中64%的成员还患有抑郁症、焦虑症和/或药物使用障碍。失眠症患者的医疗费用总额中位数是无失眠症患者的 4-6 倍。失眠症患者的医疗费用占总报销费用的比例过高(21.1%)。 研究结果表明,在一个庞大的投保群体中,失眠症患者的临床需求和行为健康合并症程度很高。除了临床意义之外,目前的研究结果还显示了充分治疗失眠症的巨大经济需求和机会。尤其是对于患有失眠症并发抑郁症、焦虑症和/或药物使用障碍的高比例成员而言。总之,研究结果表明,支付者和医疗服务提供者在促进人们更加关注睡眠和失眠问题方面可以发挥重要作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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