Reducing the Cost of Frequent Hospital Admissions for Congestive Heart Failure

Jerant, Anthony F; Azari, Rahman; Nesbitt, Thomas S.

doi:10.1097/00005650-200111000-00010

Cited by 279 publications

(267 citation statements)

References 38 publications

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“…Approximately 50% of both cohorts incurred no inpatient costs, and the UC group's SD was more than twice as high as the TELE group's. Similarly, the CHF telecare study, 3 which had a nonsignificant total cost difference, reported that at least 50% of the cohort had no hospitalizations and ED costs, and the SD for their usual care group was almost four times higher than for their telecare group. This large variability likely reflects variations in hospital stays within both groups.…”

Section: Discussionmentioning

confidence: 98%

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial (Tele-ERA)

Upatising

Wood

Kremers

et al. 2015

Telemedicine and e-Health

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Background: From 1992 to 2008, older adults in the United States incurred more healthcare expense per capita than any other age group. Home telemonitoring has emerged as a potential solution to reduce these costs, but evidence is mixed. The primary aim of the study was to evaluate whether the mean difference in total direct medical cost consequence between older adults receiving additional home telemonitoring care (TELE) (n = 102) and those receiving usual medical care (UC) (n = 103) were significant. Inpatient, outpatient, emergency department, decedents, survivors, and 30-day readmission costs were evaluated as secondary aim. Materials and Methods: Multivariate generalized linear models (GLMs) and parametric bootstrapping method were used to model cost and to determine significance of the cost differences. We also compared the differences in arithmetic mean costs. Results: From the conditional GLMs, the estimated mean cost differences (TELE versus UC) for total, inpatient, outpatient, and ED were -$9,537 (p = 0.068), -$8,482 (p = 0.098), -$1,160 (p = 0.177), and $106 (p = 0.619), respectively. Mean postenrollment cost was 11% lower than the prior year for TELE versus 22% higher for UC. The ratio of mean cost for decedents to survivors was 2.1:1 (TELE) versus 12.7:1 (UC). Conclusions: There were no significant differences in the mean total cost between the two treatment groups. The TELE group had less variability in cost of care, lower decedents to survivors cost ratio, and lower total 30-day readmission cost than the UC group.

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Section: Discussionmentioning

confidence: 98%

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial (Tele-ERA)

Upatising

Wood

Kremers

et al. 2015

Telemedicine and e-Health

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“…The telephone has been used as a medium for therapeutic interventions in general medicine and psychiatry (Baer et al, 1995;Greist et al, 1998;Jerant, Azari, & Nesbitt, 2001;Ries, Kaplan, Myers, & Prewitt, 2003;Roter et al, 1998;Wasson et al, 1992). Telephone counseling has also been effective as a smoking cessation intervention (Lichtenstein, Glasgow, Lando, Ossip-Klein, & Boles, 1996;Wadland, Soffelmayr, & Ives, 2001).…”

Section: History Of Focused Continuing Care (Fcc)mentioning

confidence: 99%

Extending residential care through telephone counseling: Initial results from the Betty Ford Center Focused Continuing Care protocol

Cacciola

Camilleri

Carise

et al. 2008

Addictive Behaviors

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There is increasing evidence that a chronic care model may be effective when treating substance use disorders. In 1996, the Betty Ford Center (BFC) began implementing a telephone-based continuing care intervention now called Focused Continuing Care (FCC) to assist and support patients in their transition from residential treatment to longer-term recovery in the "real world". This article reports on patient utilization and outcomes of FCC. FCC staff placed clinically directed telephone calls to patients (N=4094) throughout the first year after discharge. During each call, a short survey was administered to gauge patient recovery and guide the session. Patients completed an average of 5.5 (40%) of 14 scheduled calls, 58% completed 5 or more calls, and 85% were participating in FCC two months post-discharge or later. There was preliminary evidence that greater participation in FCC yielded more positive outcomes and that early post-discharge behaviors predict subsequent outcomes. FCC appears to be a feasible therapeutic option. Efforts to revise FCC to enhance its clinical and administrative value are described.

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“…Different approaches of Telemonitoring and Telecare have proven useful and possibly cost-effective [6][7][8][9][10][11][12][13][14][15][16][17]: their positive results, including improvement in the quality of life, have been emphasized by some meta-analyses [18,19]. However, in multicenter randomized studies the reduction in hospital admissions and mortality has been less convincing [20,21], so that current European Guidelines do not include telemonitoring and telecare for the management of chronic heart failure [22].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Psycological Telemonitoring and Telecare of High Risk Patientswith Chronic Heart Failure through Wireless Technologies: The Icaros Project

Aless¹,

Villani²,

Malfatto³

et al. 2013

J Clin Exp Cardiolog

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Background: Disease management is mandatory for the home care of most patients with chronic heart failure. We report the results of ICAROS (Integrated care vs Conventional intervention in cArdiac failure patients: Randomized Open label Study), an Italian trial of telemonitoring and telecare combining wireless and mobile technologies to obtain optimal therapeutic control, fast and effective interpretation of clinical data and improved patients' adherence.

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Reducing the Cost of Frequent Hospital Admissions for Congestive Heart Failure

Cited by 279 publications

References 38 publications

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial (Tele-ERA)

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial (Tele-ERA)

Extending residential care through telephone counseling: Initial results from the Betty Ford Center Focused Continuing Care protocol

Clinical and Psycological Telemonitoring and Telecare of High Risk Patientswith Chronic Heart Failure through Wireless Technologies: The Icaros Project

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