Access and models of obstructive sleep apnea care: a cross-national comparison of Canadian and Australian patient survey data

Study Objectives: We aimed to describe similarities and differences in obstructive sleep apnea (OSA) care pathways and their impact on patients in Australia and Canada, including among urban vs rural participants. 

Methods: In this secondary data analysis of patient surveys exploring OSA care in Australia and Canada, we recruited adults with a prior diagnosis of OSA from market research companies, social media, and patient-facing medical associations. Residential postal codes were used to classify participants as urban or rural. Survey domains included wait times and travel distances for care, providers, and treatments. 

Results: Data from 589 Canadians (21% rural; 42% female; mean [standard deviation] age = 57 [13] years) and 412 Australians (38% rural; 45% female; mean [standard deviation] age = 58 [14] years) with OSA were included. Participants in both countries most commonly sought initial care for suspected OSA from a primary care practitioner. Canadian participants waited longer to seek care than Australian participants (37% vs 51% within 12 months of symptom onset). Wait times for diagnostic testing were longer in Canada (59% vs 76% within 3 months of initial assessment), especially in urban settings (58% vs 78%). In both countries, > 80% of participants were offered positive airway pressure therapy. Overall, a greater variety of treatments were offered and used by Australian participants. 

Conclusions: Greater access to diagnostic testing and a greater variety of treatments were found in Australia compared to Canada. Further research is needed to determine whether reduced diagnostic wait times and presentation of increased therapy options found in Australia translate to better patient outcomes.