Resources and Delays in the Diagnosis of Sleep Apnea-Hypopnea Syndrome

Jiménez, Juan Fernando Masa; Illa, Ferran Barbé; Gil, Francisco Capote; Vives, Eusebio Chiner; de Ataur, Josefa Díaz; Cantoll, Joaquín Durán; Ortiz, Salvador López; Trigo, José María Marín; Canal, José María Montserrat; González, Manuela Rubio; Santos, Joaquín Terán; Sanz, Carlos Zamarrón; for the Working Group

doi:10.1016/S1579-2129(07)60050-0

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Abstract

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Objective

The demand for consultations and diagnostic studies for sleep apnea-hypopnea syndrome (SAHS) has increased, and this has led to considerable delays. We therefore need an updated evaluation of the diagnostic situation to serve as a management tool for specialists and health care administrations responsible for solving the problem. The objective of the present study was to carry out a descriptive analysis of the situation regarding the diagnosis of SAHS in Spanish hospitals.

Methods

We undertook a descriptive cross-sectional observational study. Public and private hospitals listed in the Ministry of Health's 2005 catalog of health care institutions were contacted, and those that routinely evaluate patients for SAHS were included in the study. The person in charge of each hospital filled in a questionnaire concerning the availability of resources and waiting periods for diagnosis.

Results

Of the 741 hospitals we contacted, 217 routinely evaluated patients for SAHS. In 88% of these, respiratory polygraphy (RP) (n=168) or polysomnography (PSG) (n=97) was available. The mean waiting period was 61 days for consultation and 224 days for RP. The mean number of RP devices was 0.99 per 100 000 inhabitants, while the recommended number is 3 per 100 000 inhabitants. The mean waiting period for PSG was 166 days. The mean number of PSG beds was 0.49 per 100 000 inhabitants, while the recommended number is 1 per 100 000.

Conclusions

We observed a marked inadequacy of resources that has led to unacceptable waiting periods. While there has been a favorable change in the situation regarding SAHS diagnosis compared to previous studies, there is still room for improvement and it is urgent that health care authorities allocate more resources to this public health problem.

Key words:

Sleep apnea

Respiratory Polygraphy

Polysomnography

Delays

Waiting lists

Objetivo

La demanda de consultas y estudios diagnósticos del síndrome de apneas-hipopneas durante el sueño (SAHS) se ha incrementado, lo que ha llevado a importantes demoras. Por tanto, es precisa una evaluación actualizada de la situación del diagnóstico que sirva como herramienta de gestión a especialistas y las administraciones sanitarias que tienen la responsabilidad de solventar el problema. El objetivo del presente estudio ha sido realizar un análisis descriptivo de la situación del diagnóstico del SAHS en los hospitales españoles.

Métodos

Se ha realizado un estudio descriptivo, observacional y transversal. Se estableció contacto con los centros públicos y privados incluidos en el catálogo de instituciones sanitarias del Ministerio de Sanidad de 2005. Se incluyeron aquellos que evaluaban habitualmente a pacientes con SAHS. El responsable de cada centro rellenó un cuestionario sobre disponibilidad de recursos y demoras para el diagnóstico.

Resultados

De los 741 centros con los que se estableció contacto, 217 evaluaban habitualmente a pacientes con SAHS. El 88% disponía de poligrafía respiratoria (PR) (n = 168) o polisomnografía (PSG) (n = 97). La demora media en consulta fue de 61 días, y la demora media para realizar PR, de 224 días. La media de equipos de PR fue de 0,99/100.000 habitantes, cuando lo recomendable es 3/100.000. La demora media para PSG fue de 166 días. La media de camas de PSG fue de 0,49/100.000 habitantes y lo recomendable es 1/100.000.

Conclusiones

Se observa una notable deficiencia de recursos que lleva a inaceptables listas de espera. Aunque la situación del diagnóstico de SAHS ha cambiado favorable-mente con respecto a estudios previos, sigue siendo mejorable y es imprescindible que las autoridades sanitarias dediquen más recursos a este problema de salud pública.

Palabras clave:

Apneas del sueño

Poligrafía respiratoria

Polisomnografía

Demoras

Lista de espera

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