Health Insurance which refuses reimbursements if you do not follow your treatment: this is not a disaster scenario but indeed a reality for patients who suffer from sleep apnea. As reported by Prof. Alain Didier, president of the French-speaking Pneumology Society currently in Congress in Marseille, since last fall, patients who benefit from a continuous positive pressure device (CPAP) must now be forced to wear this mask at least 3 hours per night and 20 days per month, under penalty of not being reimbursed by social security.
Continuous positive pressure: how does it work?
It is “the” standard treatment for sleep apnea. Continuous positive airway pressure (CPAP) is a device made up of a mask connected to a box, which injects a continuous pressure of air into the patient’s upper airways in order to prevent sagging of the pharynx, the main cause of apnea of the patient. sleep.
A remote monitoring system transmits monitoring data to the provider who provides the CPAP: number of hours of use, average air pressure, residual apneas, any mask leaks, etc. are thus monitored. The service provider then feeds this data back to the Health Insurance and the attending physician.
If the device is used at least three hours a day, the renter of the device is fully reimbursed, otherwise the payment is decreasing. In the event of a little too frequent underuse (you still have the right to have a bad cold or to go on vacation!), The remuneration is reduced by half. If on two or three occasions, compliance is too low, the patient will be forced to return the device or take charge of it.
“In fact, what matters is understanding poor adherence: is the mask poorly suited to the patient? Does it make him suffer? Does too much pressure bother him? It is thanks to dialogue and therapeutic education that compliance will be improved, ”insists Professor Didier.
It should be noted that all the patients who are treated for sleep apnea will have to be on “teleobservance” by 2016.
