A cost analysis of remote monitoring in a heart failure program

Williams, Cynthia; Wan, Thomas T. H.

doi:10.1080/01621424.2016.1227009

Cited by 12 publications

(30 citation statements)

References 19 publications

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“…Patient inclusion criteria for previous hospitalizations differed among the studies. If a hospital admission was required for inclusion, this was most often (n=10) within 7 days of discharge [ 4 , 23 , 24 , 29 , 35 , 37 , 39 - 42 ]. Inclusion was started within 1 month of index hospitalization for 2 studies [ 20 , 25 ], and 5 studies [ 21 , 32 , 43 - 45 ] included patients within 6 months.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 9 studies reported outcome measures related to non-ED health care visits. These visits comprised outpatient visits [ 20 , 22 , 23 , 26 , 36 , 45 , 47 ], primary care visits [ 33 , 45 ], home visits by nurse [ 37 , 45 ], urgent care visits [ 33 ], and telephone contacts [ 47 ]. Most (6/9, 67%) of these studies found that their telemonitoring intervention was associated with a significant increase in non-ED health care visits [ 22 , 23 , 26 , 33 , 37 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Noninvasive Telemonitoring for Chronic Heart Failure on Health Care Utilization: Systematic Review

Auener¹,

Remers²,

Dulmen³

et al. 2021

J Med Internet Res

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Background Chronic heart failure accounts for approximately 1%-2% of health care expenditures in most developed countries. These costs are primarily driven by hospitalizations and comorbidities. Telemonitoring has been proposed to reduce the number of hospitalizations and decrease the cost of treatment for patients with heart failure. However, the effects of telemonitoring on health care utilization remain unclear. Objective This systematic review aims to study the effect of telemonitoring programs on health care utilization and costs in patients with chronic heart failure. We assess the effect of telemonitoring on hospitalizations, emergency department visits, length of stay, hospital days, nonemergency department visits, and health care costs. Methods We searched PubMed, Embase, and Web of Science for randomized controlled trials and nonrandomized studies on noninvasive telemonitoring and health care utilization. We included studies published between January 2010 and August 2020. For each study, we extracted the reported data on the effect of telemonitoring on health care utilization. We used P<.05 and CIs not including 1.00 to determine whether the effect was statistically significant. Results We included 16 randomized controlled trials and 13 nonrandomized studies. Inclusion criteria, population characteristics, and outcome measures differed among the included studies. Most studies showed no effect of telemonitoring on health care utilization. The number of hospitalizations was significantly reduced in 38% (9/24) of studies, whereas emergency department visits were reduced in 13% (1/8) of studies. An increase in nonemergency department visits (6/9, 67% of studies) was reported. Health care costs showed ambiguous results, with 3 studies reporting an increase in health care costs, 3 studies reporting a reduction, and 4 studies reporting no significant differences. Health care cost reductions were realized through a reduction in hospitalizations, whereas increases were caused by the high costs of the telemonitoring program or increased health care utilization. Conclusions Most telemonitoring programs do not show clear effects on health care utilization measures, except for an increase in nonemergency outpatient department visits. This may be an unwarranted side effect rather than a prerequisite for effective telemonitoring. The consequences of telemonitoring on nonemergency outpatient visits should receive more attention from regulators, payers, and providers. This review further demonstrates the high clinical and methodological heterogeneity of telemonitoring programs. This should be taken into account in future meta-analyses aimed at identifying the effective components of telemonitoring programs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Effect of Noninvasive Telemonitoring for Chronic Heart Failure on Health Care Utilization: Systematic Review

Auener¹,

Remers²,

Dulmen³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…For example, RPM has been shown to reduce health service utilization and costs (e.g., hospitalization and emergency room (ER) visits) among patients with CHF [2,[8][9][10][11][12], whereas other studies did not find similar findings [6,7,13,14]. Furthermore, some studies reported inconclusive findings [15][16][17].…”

Section: Introductionmentioning

confidence: 57%

“…There has been an increasing amount of literature on the potential value of RPM for patients with COPD and/or CHF; however, literature has shown both supportive and opposing evidence for RPM [1,6,7]. For example, RPM has been shown to reduce health service utilization and costs (e.g., hospitalization and emergency room (ER) visits) among patients with CHF [2,[8][9][10][11][12], whereas other studies did not find similar findings [6,7,13,14].…”

Section: Introductionmentioning

confidence: 83%

A Remote Patient Monitoring Intervention for Patients With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Pre-Post Economic Analysis of the Smart Program (Preprint)

Isaranuwatchai¹,

Redwood²,

Schauer³

et al. 2018

Preprint

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BackgroundExacerbations of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are associated with high health care costs due to increased emergency room (ER) visits and hospitalizations. Remote patient monitoring (RPM) interventions aim to improve monitoring of symptoms to detect early deterioration and provide self-management strategies. As a result, RPM aims to reduce health resource utilization. Studies have inconsistently reported the benefits of RPM in chronic illnesses. The Smart Program is a RPM intervention that aims to provide clinical benefit to patients and economic benefit to health care payers.

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“…A growing amount of literature exists on the potential value of RPM for patients with COPD and CHF; however, the literature has shown both supportive and opposing evidence for RPM [1,6,7]. For example, RPM has been shown to reduce health service utilization and costs (eg, hospitalization and emergency room [ER] visits) among patients with CHF [2,8-12], whereas other studies did not find similar findings [6,7,13,14]. Conversely, some studies reported inconclusive findings [15-17].…”

Section: Introductionmentioning

confidence: 99%

A Remote Patient Monitoring Intervention for Patients With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Pre-Post Economic Analysis of the Smart Program

Isaranuwatchai

Redwood²,

Schauer³

et al. 2018

JMIR Cardio

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BackgroundExacerbation of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are associated with high health care costs owing to increased emergency room (ER) visits and hospitalizations. Remote patient monitoring (RPM) interventions aim to improve the monitoring of symptoms to detect early deterioration and provide self-management strategies. As a result, RPM aims to reduce health resource utilization. To date, studies have inconsistently reported the benefits of RPM in chronic illnesses. The Smart Program is an RPM intervention that aims to provide clinical benefit to patients and economic benefit to health care payers.ObjectiveThis study aims to economically evaluate the potential benefits of the Smart Program in terms of hospitalizations and ER visits and, thus, associated health care costs from the perspective of the public health care system.MethodsSeventy-four patients diagnosed with COPD or CHF from one hospital site were included in this one-group, pre-post study. The study involved a secondary data analysis of deidentified data collected during the study period – from 3 months before program initiation (baseline), during the program, to 3 months after program completion (follow-up). Descriptive analysis was conducted for the study population characteristics at baseline, the clinical frailty score at baseline and 3-month follow-up, client satisfaction at 3-month follow-up, and number and costs of ER visits and hospitalizations throughout the study period. Furthermore, the cost of the Smart Program over a 3-month period was calculated from the perspective of the potential implementer.ResultsThe baseline characteristics of the study population (N=74) showed that the majority of patients had COPD (50/74, 68%), were female (42/74, 57%), and had an average age of 72 (SD 12) years. Using the Wilcoxon signed-rank test, the number of ER visits and hospitalizations, including their associated costs, were significantly reduced between baseline and 3-month follow-up (P<.001). The intervention showed a potential 68% and 35% reduction in ER visits and hospitalizations, respectively, between the 3-month pre- and 3-month postintervention period. The average cost of ER visits reduced from Can $243 at baseline to Can $67 during the 3-month follow-up, and reduced from Can $3842 to Can $1399 for hospitalizations.ConclusionsIn this study, the number and cost of ER visits and hospitalizations appeared to be markedly reduced for patients with COPD or CHF when comparing data before and after the Smart Program implementation. Recognizing the limitations of the one-group, pre-post study design, RPM requires an upfront investment, but it has the potential to reduce health care costs to the system over time. This study represents another piece of evidence to support the potential value of RPM among patients with COPD or CHF.

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A cost analysis of remote monitoring in a heart failure program

Cited by 12 publications

References 19 publications

The Effect of Noninvasive Telemonitoring for Chronic Heart Failure on Health Care Utilization: Systematic Review

The Effect of Noninvasive Telemonitoring for Chronic Heart Failure on Health Care Utilization: Systematic Review

A Remote Patient Monitoring Intervention for Patients With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Pre-Post Economic Analysis of the Smart Program (Preprint)

A Remote Patient Monitoring Intervention for Patients With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Pre-Post Economic Analysis of the Smart Program

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