ECONOMIC AND OPERATIONAL IMPACT OF A FULLY DIGITAL DIAGNOSTIC PATHWAY FOR OBSTRUCTIVE SLEEP APNOEA IN THE NHS: A TIME-DRIVEN ACTIVITY-BASED COSTING ANALYSIS
Author(s)
Ankit Ghildiyal, M.Pharm, MSc1, Asad Ali, FRCP2, Joanna Murphy, MBA1, Jamie Inns, BSc1.
1Resmed UK, Oxfordshire, United Kingdom, 2University Hospitals Coventry and Warwickshire NHS Trust, West Midlands, United Kingdom.
1Resmed UK, Oxfordshire, United Kingdom, 2University Hospitals Coventry and Warwickshire NHS Trust, West Midlands, United Kingdom.
OBJECTIVES: To evaluate the provider-level cost and resource implications of a fully digital diagnostic pathway for obstructive sleep apnoea (OSA) compared with the current NHS diagnostic pathway.
METHODS: A time-driven activity-based costing (TDABC) model was developed to map the referral-to-diagnosis pathway for adults undergoing assessment for suspected OSA. Resource utilisation and activity duration estimates were derived from three NHS service evaluations conducted at Betsi Cadwaladr University Health Board, Northumbria Healthcare NHS Foundation Trust, and University Hospitals Coventry and Warwickshire NHS Trust, previously presented at ARTP 2026. A hypothetical cohort of 2,000 patients was modelled. The digital pathway incorporated electronic referral, remote triage, home-based diagnostic testing, automated device logistics, and cloud-based analysis (AirConnect Dx). Staff costs were assigned using NHS Agenda for Change salary bands and national on-cost assumptions. Comparator testing costs were informed by the National Average Unit Cost for Respiratory Sleep Study (HRG DZ50Z) from the NHS National Cost Collection (2024/25). AirConnect Dx was modelled using an indicative per-study cost of £215, recognising that pricing may vary according to testing volumes and service configuration. Analyses were conducted from an NHS provider perspective.
RESULTS: Compared with the current NHS diagnostic pathway, the fully digital pathway reduced total costs by 24 %, reducing the average cost per patient from £376 to £285. Healthcare professional resource requirements decreased by 62%, with average staff time per patient reduced from 208 to 80 minutes. Reduced administrative burden, repeat testing, result processing, and reporting activities translated into a 2.6-fold increase in potential diagnostic capacity within existing service resources.
CONCLUSIONS: A fully digital OSA diagnostic pathway reduced provider costs and healthcare professional workload while increasing diagnostic capacity. This approach may improve operational efficiency and help NHS sleep services address growing diagnostic demand.
METHODS: A time-driven activity-based costing (TDABC) model was developed to map the referral-to-diagnosis pathway for adults undergoing assessment for suspected OSA. Resource utilisation and activity duration estimates were derived from three NHS service evaluations conducted at Betsi Cadwaladr University Health Board, Northumbria Healthcare NHS Foundation Trust, and University Hospitals Coventry and Warwickshire NHS Trust, previously presented at ARTP 2026. A hypothetical cohort of 2,000 patients was modelled. The digital pathway incorporated electronic referral, remote triage, home-based diagnostic testing, automated device logistics, and cloud-based analysis (AirConnect Dx). Staff costs were assigned using NHS Agenda for Change salary bands and national on-cost assumptions. Comparator testing costs were informed by the National Average Unit Cost for Respiratory Sleep Study (HRG DZ50Z) from the NHS National Cost Collection (2024/25). AirConnect Dx was modelled using an indicative per-study cost of £215, recognising that pricing may vary according to testing volumes and service configuration. Analyses were conducted from an NHS provider perspective.
RESULTS: Compared with the current NHS diagnostic pathway, the fully digital pathway reduced total costs by 24 %, reducing the average cost per patient from £376 to £285. Healthcare professional resource requirements decreased by 62%, with average staff time per patient reduced from 208 to 80 minutes. Reduced administrative burden, repeat testing, result processing, and reporting activities translated into a 2.6-fold increase in potential diagnostic capacity within existing service resources.
CONCLUSIONS: A fully digital OSA diagnostic pathway reduced provider costs and healthcare professional workload while increasing diagnostic capacity. This approach may improve operational efficiency and help NHS sleep services address growing diagnostic demand.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE419
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)