Evaluation of a Care Coordination/Home-Telehealth Program for Veterans with Diabetes

Abstract

We evaluated a Veterans Health Administration (VHA) care coordination/ home-telehealth (CC/HT) program on the utilization of health care services and health-related quality of life (HRQL) in veterans with diabetes. Administrative records of 445 veterans with diabetes were reviewed to compare health care service utilization in the 1-year period before and 1-year period post-enrollment and also examined self-reported HRQL at enrollment and 1 year later. Multivariate analyses indicated a statistically significant reduction in the proportion of patients who were hospitalized (50% reduction), emergency room use (11% reduction), reduction in the average number of bed days of care (decreased an average of 3.0 days), and improvement in the HRQL role-physical functioning, bodily pain, and social functioning. The results need to be interpreted with caution because we used a single-group study design that may be influenced by regression to the mean. Ideally, future research should use a randomized controlled trial design.

Promoting Access Through Complementary eHealth Technologies: Recommendations for VA’s Home Telehealth and Personal Health Record Programs

“…Previous studies of veterans with chronic conditions who used CCHT have shown lower mortality 24 and healthcare utilization [25][26][27] , as well as improved quality of life 26 and more timely receipt of care 28 . Other work has found increased time to readmission among veterans with heart failure 29 , including a dose-response relationship 30,31 .…”

The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

“…[56][57][58][59][60][61][62][63][64][65] Of these, five were reported by the same senior author with different coauthors. These VHA studies are presented here in historical order as a set, shown in Table 3.…”

“…An observational study (n = 445) of the effects of the Care Coordination Home Telehealth program on use of service and quality of life was conducted among patients in the South Florida-Puerto Rico and Georgia VHA region (published in 2005). 56 The authors pointed out that diabetes was the second most prevalent condition among veterans in this region and that ''4% of the population (more than 1 million veterans, nationwide) were consuming 40% of the healthcare resources.'' 56 The analysis of utilization data was based on administrative records, starting at baseline and after 12 months of participation in the program.…”

Changing the location of care: Management of patients with chronic conditions in Veterans Health Administration using care coordination/home telehealth

“…Outcomes analyses of CCHT in VHA have shown reduced hospitalizations, 30 percent fewer emergency room visits, a 30 percent reduction in the average number of bed days of care, improved health-related quality of life [22], and benefits in terms of satisfaction [23], use clinical outcomes [24][25], and cost. CCHT supports rehabilitation in the home and improved instrumental activities of daily living and cognitive function [25].…”