Ht. Hatoum et al., Insomnia, health-related quality of life and healthcare resource consumption - A study of managed-care organisation enrollees, PHARMACOECO, 14(6), 1998, pp. 629-637
Objective: insomnia is a prevalent sleep complaint which has been reported
to be greatly associated with reduced health-related quality of life (HR-QO
L) and increased healthcare resource use. This study documents the prevalen
ce of insomnia, and its impact on patients' HR-QOL and healthcare resource
use in managed-care settings in the US.
Design and Setting: A multi site survey of 5 American Medical Group Associa
tion(R) (AMGA) clinics was conducted. Each clinic mailed questionnaires to
1100 randomly selected individuals enrolled in its healthcare system and di
stributed questionnaires to 400 individuals during a clinic visit and prior
to seeing a physician. The questionnaire was a form of the Health Status Q
uestionnaire with the well-validated Medical Outcomes Study 36-Item Short F
orm (SF-36) Health Survey, a 3-question depression screen, a sleep question
naire, demographic variables, and questions about medical encounters and pr
escription and over-the-counter (OTC) drug use.
Main outcome measures and results: Approximately one-third of managed-care
enrollees in this study reported insomnia with daytime dysfunction. Individ
uals with insomnia reported lower HR-QOL scores and increased healthcare re
source use compared with individuals with no insomnia. After controlling fo
r demographic variables and comorbid conditions, the negative association o
f insomnia remained significant on all HR-QOL scores, emergency room visits
, calls to the physician and OTC drugs use.
Conclusions: Insomnia is significantly associated with reduced HR-QOL and i
ncreased healthcare resource use in enrollees of managed-care organisations
.