A Prenatal Remote Monitoring Program in Pregnancies Complicated with Gestational Hypertensive Disorders: What Are the Contributors to the Cost Savings?

Abstract

Background: In 2015, we performed a cost analysis of a prenatal remote monitoring (RM) program compared with conventional care (CC) for women diagnosed with gestational hypertensive disorders (GHD). Introduction: We investigated where the cost savings were distributed by dividing our patient population into three subgroups, according to the gestational age (GA) at the time of delivery: (1) <34 weeks; (2) 34-37 weeks; and (3) >37 weeks of GA. Materials and Methods: Healthcare costs were calculated from patient-specific hospital bills at Ziekenhuis Oost Limburg (Genk, Belgium) in 2015-2016. Cost comparisons were made from the perspectives of the Belgium national healthcare system (HCS), the National Institution for Insurance of Disease and Disability (RIZIV), and the costs to individual patients. Results: A total of 256 pregnant women were included, 80 (31.25%) of whom received RM and 176 (68.75%) of whom received CC. The greatest difference in costs between RM and CC was in the group that delivered before 34 weeks of GA, followed by the group who delivered after 37 weeks of GA, and then the group of women who delivered at 34-37 weeks of GA. Most of the cost savings were in neonatal care, for both the three separate study subgroups and the total study group. Discussion and Conclusion: Our data showed that RM is more cost-effective than CC for pregnant women with GHD. Further investigation of the effects of RM on the long-term economic and social costs is recommended, together with an analysis of the price that should be asked for RM services.

Feasibility of Using Blood Pressure Self-Monitoring and the Epic MyChart Blood Pressure Flowsheet to Monitor Blood Pressure After Preeclampsia

“…Several studies have found that self-monitoring of BP is an effective means to monitor BP in the immediate postpartum period in women with preeclampsia. 3,[19][20][21] Cairns et al 3 reported that BP self-monitoring after a pregnancy affected by preeclampsia is a feasible strategy to assist with BP management. Blood pressure self-monitoring may be more cost effective than conventional obstetric follow-up care.…”

“…Blood pressure self-monitoring may be more cost effective than conventional obstetric follow-up care. 20 Hirshberg et al 19 found that, after discharge, women with preeclampsia were more likely to submit BPs using text-based monitoring than attend a traditional office visit for BP follow-up. Currently, best practices regarding how often to evaluate and monitor women after preeclampsia remain unclear.…”

“…Cairns et al 3 reported that BP self-monitoring after a pregnancy affected by preeclampsia is a feasible strategy to assist with BP management. Blood pressure self-monitoring may be more cost effective than conventional obstetric follow-up care 20 . Hirshberg et al 19 found that, after discharge, women with preeclampsia were more likely to submit BPs using text-based monitoring than attend a traditional office visit for BP follow-up.…”

Using mHealth in postpartum women with pre‐eclampsia: Lessons learned from a qualitative study

“…Current evidence‐based practices indicate that pregnancies complicated by pre‐eclampsia can be monitored closely on an outpatient basis with frequent clinic visits before delivery or inpatient hospital monitoring until delivery . Such monitoring could be achieved remotely, safely, and effectively through the combination of using mobile health (mHealth) technologies and outpatient services for appropriate management . A remote monitoring using mHealth in pregnant women during the prenatal period has shown positive results in decreasing healthcare costs and improving outcomes in newborns .…”

“…1,2 Such monitoring could be achieved remotely, safely, and effectively through the combination of using mobile health (mHealth) technologies and outpatient services for appropriate management. [3][4][5][6][7][8] A remote monitoring using mHealth in pregnant women during the prenatal period has shown positive results in decreasing healthcare costs and improving outcomes in newborns. 6,9 It offers patients the ability to better manage chronic conditions, transfers real-time information with integrated devices, improves clinical decision-making, provides necessary emergency care, and delivers patient care directly at their homes, which makes healthcare more accessible.…”