Cost and Efficiency of Drug-Induced Sleep Endoscopy: Endoscopy Suite Versus Outpatient Surgery Center.

Abstract

Drug-induced sleep endoscopy (DISE) is used to identify airway obstruction patterns in patients with obstructive sleep apnea (OSA). This procedure is typically performed in either the traditional operating room (OR) or an outpatient surgery center (SC). There is limited data regarding the cost and efficiency of DISE in the endoscopy suite (ES). This study compares the cost, efficiency, and safety of DISE performed in the ES compared to the SC. This retrospective review included patients who underwent DISE between July 2023 and April 2024 at a single tertiary care center. Consecutive patients with CPAP-intolerant OSA undergoing DISE in the ES or SC were included. Patient demographics, sleep studies, procedure-related costs, procedure duration characteristics, and anesthesia documentation were analyzed. Eighty-four patients (36 ES, 48 SC) were included. Patient sex, age, BMI, and preoperative AHI/REI were similar in both cohorts (p > 0.05). DISE in the ES significantly reduced total facility time (48 min, p < 0.0001), time in procedure room (6.6 min, p < 0.0001), DISE procedure time (1.7 min, p = 0.0034), total recovery time (30.4 min, p < 0.0001), and procedure room turnover time (7.1 min, p = 0.0012). Costs for ES procedures were 39.35% lower, specifically in costs associated with anesthesia, operating room, and recovery room (all comparisons, p < 0.001). No complications occurred in either group. Performing DISE in the ES increases efficiency and reduces costs compared to the outpatient SC while maintaining safety for patients with CPAP-intolerant OSA.