Cost utility analysis of continuous and intermittent versus intermittent vital signs monitoring in patients admitted to surgical wards

Abstract

Background: Complications after surgical procedures are common and can lead to a prolonged hospital stay, increased rates of postoperative hospital readmission, and increased mortality. Monitoring vital signs is an effective way to identify patients who are experiencing a deterioration in health. SensiumVitals is wireless system that includes a lightweight, digital patch that monitors vital signs at two minute intervals, and has shown promise in the early identification of patients at high risk of deterioration. Objective: To evaluate the cost-utility of continuous monitoring of vital signs with SensiumVitals in addition to intermittent monitoring compared to the usual care of patients admitted to surgical wards. Methods: A de novo decision analytic model, based on current treatment pathways, was developed to estimate the costs and outcomes. Results from randomised clinical trials and national standard sources were used to inform the model. Costs were estimated from the NHS and PSS perspective. Deterministic and probabilistic sensitivity analyses (PSA) were conducted to explore uncertainty surrounding input parameters. Results: Over a 30-day time horizon, intermittent monitoring in addition to continuous monitoring of vital signs with SensiumVitals was less costly than intermittent vital signs monitoring alone. The total cost per patient was £6,329 versus £5,863 for the comparator and intervention groups respectively and the total effectiveness per patient was 0.057 QALYs in each group. Results from the PSA showed that use of SensiumVitals in addition to intermittent monitoring has 73% probability of being costeffective at a £20,000 willingness-to-pay threshold and 73% probability of being cost-saving compared to the comparator. Cost savings were driven by reduced costs of hospital readmissions and length of stays in hospital. Conclusions: Use of SensiumVitals as a postoperative intervention for patients on surgical wards is a cost-saving and cost-effective strategy, yielding improvements in recovery with decreased health resource use. KEY POINTS FOR DECISION MAKERS SensiumVitals has the potential to reduce the length of postoperative hospital stay, readmission rates, and associated costs in postoperative patients. In this study, SensiumVitals has been found to be a cost-saving (dominant) and cost-effective (dominant) intervention for monitoring the vital signs of surgical patients postoperatively.

Effect of Intelligent Vital Sign Monitoring System on Postoperative Nursing Care of Severe Patients

“…Researchers have developed a Wearable ECG monitoring system for cardiovascular diseases [ 3 ]. By embedding ECG and acceleration sensors in wearable systems, the system realizes the integrated design of the ECG electrode and wearable clothing, which is convenient for daily monitoring of patients.…”

The impact of wearable continuous vital sign monitoring on deterioration detection and clinical outcomes in hospitalised patients: a systematic review and meta-analysis

“…Higher risk patients are often continuously monitored (for example in critical care), improving early detection of deterioration [ 5 ]. However, in the UK, continuous monitoring is not commonly used in the ward environment [ 9 ], although one study suggests it may be feasible and cost-effective in surgical wards [ 10 ], with the potential to improve patient outcomes when compared to intermittent monitoring [ 8 ].…”

Protocol for a systematic review assessing ambulatory vital sign monitoring impact on deterioration detection and related clinical outcomes in hospitalised patients

“…7 8 Another study suggested that implementing continuous monitoring in surgical wards was also cost effective. 8 However, clinical staff interviews indicate that despite the benefits and potential to increase the timely detection of patient deterioration, limitations in continuous vital sign monitoring technology can pose a barrier to implementation. 2 One of the main suggested reasons identified was invasiveness and restricted mobility.…”