Trends in Soft Palate Surgery and Reimbursements for Obstructive Sleep Apnea Among the Medicare Population.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY Annals of Otology Rhinology and Laryngology Pub Date : 2024-10-24 DOI:10.1177/00034894241288435

Sina J Torabi, Madelyn I Frank, Rahul A Patel, R Peter Manes, Edward C Kuan, Douglas K Trask

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Abstract

Objectives: This study aims to analyze trends in utilization and reimbursement of soft palate surgery for OSA using the Medicare national database.

Methods: A retrospective analysis of the 2000 to 2021 Part B National Summery datafiles using current Procedural Terminology (CPT) codes 42145 (uvulopalatopharyngoplasty [UPPP]), 42950 (pharyngoplasty [PP]), and 42140 (uvulectomy [UVU]) was performed.

Results: Between 2000 and 2021, the number of OSA surgeries fell 65.7% from 4208 to 1443. UPPP fell 87.6% from 3455 in 2000 to 428 in 2021 (P < .001). UVU also fell in popularity, from 568 to 376 (33.8%; P < .001). In contrast, the performance of PP rose 245.4% over time, from 185 to 639 (P < .001). When comparing 2000 to 2009, both PP and UVU rose in relative use (from 4.4% to 12.3% and from 13.5% to 20.4% of all soft palate OSA surgeries, respectively), while UPPP fell (82.1% to 67.3%; P < .001). Total Medicare payments for all 3 procedures fell 57.2% from $1 658 844 to $633 091 (P < .001). Adjusted total UPPP payments fell 88.7% (P < .001). Adjusted total PP payment rose 137.5% to $262 538 in 2021 (P < .001).

Conclusion: Soft palate surgery for OSA has declined amongst the Medicare population over 21 years (2000-2021). The more individualized and tissue sparing PP has risen in popularity but did not overcome the large decline of the traditional UPPP. Accordingly, there was a 75.7% fall in inflation-adjusted reimbursements. Overall, our data indicates a decline in soft palate surgery in the management of geriatric OSA, with modest relative increase in pharyngoplasty procedures.

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医疗保险人群中的软腭手术和阻塞性睡眠呼吸暂停的报销趋势。

研究目的本研究旨在利用医疗保险全国数据库分析治疗 OSA 的软腭手术的使用和报销趋势：方法：使用当前程序术语（CPT）代码 42145（悬雍垂腭咽成形术 [UPPP]）、42950（咽成形术 [PP]）和 42140（悬雍垂切除术 [UVU]）对 2000 年至 2021 年 B 部分国家汇总数据文件进行回顾性分析：结果：2000 年至 2021 年间，OSA 手术数量从 4208 例下降到 1443 例，降幅达 65.7%。UPPP从2000年的3455例下降到2021年的428例，降幅为87.6%（P P P P P P P P结论：21 年来（2000-2021 年），医保人群中治疗 OSA 的软腭手术有所减少。更具个性化、更能保护组织的PP越来越受欢迎，但并没有克服传统UPPP的大幅下降。因此，通货膨胀调整后的报销额下降了 75.7%。总之，我们的数据表明，在老年 OSA 的治疗中，软腭手术有所减少，而咽喉成形术则相对略有增加。

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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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.