Analisi dei costi sanitari per lo scompenso cardiaco nella regione Marche

Politi, Claudio; Deales, Alberto; Cicchitelli, F.; Marcobelli, Alberico; Barbadoro, Pamela; Zorzan, Riccardo; Stanislao, Francesco Di

doi:10.1007/bf03320547

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…The cost of heart failure care is estimated as percent of total healthcare spending equal to 13%, with the highest cost spent for hospital care, which represents 77% of total healthcare spending for heart failure [3]. The major causes of re-hospitalization are non adherence to treatment and non adherence to physician advices [4].…”

Section: Chronic Heart Failure -Future Public Healthcare Impactmentioning

confidence: 99%

Telecardiology Assistance in Senior Living Houses

Kaladjurdjevic¹

2015

JCC

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Abstract:The CHF (chronic heart failure) represents one of major cause of mortality and morbidity in developed countries. It is expected that incidence of heart failure associated with aging, will rise exponentially, due to its higher prevalence among population over 75 years. The SLH (senior living house) is missing an adequate secondary healthcare assistance in order to provide a qualitative secondary prevention to the resident. We have conducted a pilot project of telecardiology in one senior living house in 2013, with duration of 6 months; we decided to expend the project as an observational trial with primary objective to evaluate impact of telemedicine on secondary prevention of clinical cardiovascular outcomes/hospitalization in senior living house setting and secondary objectives to evaluate quality of life using Minnesota living with Heart Failure questionnaire and to evaluate cost savings and additional benefits earned by telemedicine. For the study, 85% powered at the 5% level of significance; to detect differences, we need 310 patients, including 10% drop out. As results, during the pilot project, 23 patients with median age of 86 years were monitored; we are currently enrolling new senior living house and patients with CHF that resides in senior living house.Key words: CHF, telemedicine, Telecardiology, secondary prevention, elderly. Introducton The CHF (chronic heart failure) is one of principle causes of re-hospitalization, in population over 75 years of age. With future aging process, the prevalence of cardiovascular disease will rise exponentially. The ratio of healthcare spending for elderly population is already 4 fold higher versus healthcare spending for population under 65 years old. In near future, the elderly will represent one fourth (1/4) of total population. Considering the aging process and associated increase of chronic disease prevalence in next future, healthcare systems will face financial and professional constraints in provision of qualitative and equally accessible healthcare services.The chronic heart failure represents one of major causes of mortality and morbidity in industrialized countries. The incidence of heart failure is estimated from 1 to 5 cases per 1,000 population with exponential increase in the population over 65 old, because of what heart failure is considered a disease of aging. High incidence of re-hospitalization due to frequent CHF exacerbation makes this group of patients among the highest consumer of healthcare and social services.Secondary prevention is an important gatekeeper of hospitalization and over consumption of tertiary care service. Secondary prevention can detect early signs of organ worsening and prevent further deterioration, by intervening with adequate treatment. In order to detect early symptoms, it is necessary to monitor frequently patient's vital signs.Telemedicine showed positive results in regards of secondary prevention. We posed the question whether the telecardiology assistance in long term trial of 24 months, on large sample can s...

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Section: Chronic Heart Failure -Future Public Healthcare Impactmentioning

confidence: 99%

Telecardiology Assistance in Senior Living Houses

Kaladjurdjevic¹

2015

JCC

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Improving quality of care in people with Type 2 diabetes through the Associazione Medici Diabetologi‐annals initiative: a long‐term cost‐effectiveness analysis

Giorda¹,

Nicolucci

Pellegrini

et al. 2013

Diabet. Med.

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Economic outcomes from telecardiology services

Kaladjurdjevic

Antonicelli

2017

Digital Medicine

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Background and Objectives: Owing to the scarcity of health-care financing and the pressure of aging with the associated increased incidence of chronic heart failure, new models of health-care delivery supported by technology solution require a social economic analysis. We aim to assess improvement of Kansas City Living with Cardiomyopathy Questionnaire (KCCQ) score with telehome monitoring in elderly patients affected with Chronic Heart Failure (CHF) and to estimate a probable cost saving for health-care provider and patient, by calculating a probability to reduce fatal events such as mortality and hospitalization associated with improved health status measured with the KCCQ questionnaire. Materials and Methods: An observational quasi-experimental trial was used. Eight patients affected with chronic heart failure aged 85-90 years of age who have been at least three times hospitalized within the last year were recruited for the study. These patients received an educational module to empower their self-management capacity and a medicine kit necessary for telehome monitoring. The KCCQ questionnaire was employed. The KCCQ questionnaire is an independent predictor of health-care resource utilization. The KCCQ score improvement is associated likely with rehospitalization and mortality reduction according to results from previous clinical trial, where KCCQ score has been demonstrated as a strong statistically independent predictor of mortality and rehospitalization after adjustment for other variables. Results: The KCCQ score improved for 15 points from baseline measurement, after 6 months of telehome monitoring. The improvement of KCCQ score of 15 points represents a reduction of probability of hospitalization and mortality for 18% and 16%, respectively. In addition, an individual's cost savings were calculated, using the individual's willingness to pay to avoid fatal event, individual's productivity gain by avoiding a travel to remote hospital facilities, and an improved probability of positive event with telehome monitoring. Conclusion: Analysis demonstrated a probability for an important economical saving with the use of telehome monitoring for the provider and patient. We can conclude that telehome monitoring represents an innovative service that provides clinical and economical value addition to the patient, health-care system, and society.

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Analisi dei costi sanitari per lo scompenso cardiaco nella regione Marche

Cited by 3 publications

References 5 publications

Telecardiology Assistance in Senior Living Houses

Telecardiology Assistance in Senior Living Houses

Improving quality of care in people with Type 2 diabetes through the Associazione Medici Diabetologi‐annals initiative: a long‐term cost‐effectiveness analysis

Economic outcomes from telecardiology services

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