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Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem
Chronic Care Accreditation Standards
As described earlier in this chapter, sleep disorders are chronic conditions with complex treatments. However, despite the importance of early recognition and treatment, the primary focus of most existing sleep centers is on diagnosis rather than on comprehensive management of sleep loss and sleep disorders as chronic conditions. This narrow focus may largely be the unintended result of compliance with criteria for accreditation of sleep laboratories, which emphasize diagnostic standards and reimbursement, for diagnostic testing. Clinical accreditation standards should be updated to address patient care needs.
Chronic disease management models, such as those used to provide optimal care for individuals with diabetes, asthma, congestive heart failure, and depression, have been proven to be effective at providing better-integrated care (Tsai et al., 2005). Therefore, the committee recommends that accreditation criteria for all sleep centers, embedded in either academic health centers or private sleep laboratories, be expanded to emphasize treatment, long-term patient care, and management strategies. Although sleep laboratories may face a financial burden implementing the changes, the committee believes this is the most effective way to ensure optimal patient care. Such criteria should be subject to further analysis and a demonstration that chronic care is a worthwhile investment. If such studies demonstrate a benefit, this may then change reimbursement patterns.
Recommendation 9.2: Sleep laboratories should be part of accredited sleep centers, the latter to include long-term strategies for patient care and chronic disease management.
All private and academic sleep laboratories should be under theauspices of accredited sleep centers and include adequate mechanisms to ensure long-term patient care and chronic disease management. Accreditation criteria should expand beyond a primary focuson diagnostic testing to emphasize treatment, long-term patientcare, and chronic disease management strategies.