Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPD
Background: Heart failure and chronic obstructive pulmonary disease (COPD) are leading causes of disability and lead to substantial healthcare costs. The aim of this study was to evaluate the effectiveness of home telemonitoring in reducing healthcare usage and costs in patients with heart failure o...
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doaj-15b39a0bcf1a4290a0df4f5afb63b6482021-04-02T16:37:12ZengKeAi Communications Co., Ltd.Clinical eHealth2588-91412020-01-0134048Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPDJorien M.M. van der Burg0N. Ahmad Aziz1Maurits C. Kaptein2Martine J.M. Breteler3Joris H. Janssen4Lisa van Vliet5Daniel Winkeler6Anneke van Anken7Marise J. Kasteleyn8Niels H. Chavannes9Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; Corresponding author.Department of Neurology, University of Bonn, Bonn, Germany; Population Health Sciences, German Centre for Neurodegenerative Diseases (DZNE), Bonn, GermanyJheronimus Academy of Data Science, Den Bosch, The Netherlands & Department of Statistics and Research Methods, Tilburg University, Tilburg, The NetherlandsFocusCura, Driebergen-Rijssenburg, The Netherlands; Department of Anesthesiology, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsFocusCura, Driebergen-Rijssenburg, The NetherlandsDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsRoom To, De Meern, The NetherlandsDepartment of Cardiology, Slingeland Hospital, Doetinchem, The NetherlandsDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; Department of Pulmonology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsBackground: Heart failure and chronic obstructive pulmonary disease (COPD) are leading causes of disability and lead to substantial healthcare costs. The aim of this study was to evaluate the effectiveness of home telemonitoring in reducing healthcare usage and costs in patients with heart failure or COPD. Methods: The study was a retrospective observational study with a follow-up duration of up to 3 years in which for all participants data before and after enrollment in the telemonitoring program was compared. Hundred seventy-seven patients with heart failure (NYHA functional class 3 or 4) and 83 patients with COPD (GOLD stage 3 or 4) enrolled in a home telemonitoring program in addition to receiving usual hospital care. The primary outcome was the number of hospitalizations; the secondary outcomes were total number of hospitalization days and healthcare costs during the follow-up period. Generalized Estimating Equations were applied to account for repeated measurements, adjusting for sex, age and length of follow-up. Results: In heart failure patients, after initiation of home telemonitoring both the number of hospitalizations and the total number of hospitalization days significantly decreased (incidence rate ratio of 0.35 (95% CI: 0.26–0.48) and 0.35 (95% CI: 0.24–0.51), respectively), as did the total healthcare costs (exp(B) = 0.11 (95% CI: 0.08–0.17)), all p < 0.001. In COPD patients neither the number of hospitalizations nor the number of hospitalization days changed compared to the pre-intervention period. However, the healthcare costs were about 54% lower in COPD patients after the start of the telemonitoring intervention (exp(B) = 0.46, 95% CI 0.25–0.84, p = 0.011). Conclusions: Integrated home telemonitoring significantly reduced the number of hospital admissions and days spent in hospital in patients with heart failure, but not in patients with COPD. Importantly, in both patients with heart failure and COPD the intervention substantially reduced the total healthcare costs.http://www.sciencedirect.com/science/article/pii/S2588914120300071Heart failureChronic Obstructive Pulmonary Disease (COPD)TelemonitoringRemote patient monitoring (RPM)Home monitoringHome telemonitoring |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jorien M.M. van der Burg N. Ahmad Aziz Maurits C. Kaptein Martine J.M. Breteler Joris H. Janssen Lisa van Vliet Daniel Winkeler Anneke van Anken Marise J. Kasteleyn Niels H. Chavannes |
spellingShingle |
Jorien M.M. van der Burg N. Ahmad Aziz Maurits C. Kaptein Martine J.M. Breteler Joris H. Janssen Lisa van Vliet Daniel Winkeler Anneke van Anken Marise J. Kasteleyn Niels H. Chavannes Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPD Clinical eHealth Heart failure Chronic Obstructive Pulmonary Disease (COPD) Telemonitoring Remote patient monitoring (RPM) Home monitoring Home telemonitoring |
author_facet |
Jorien M.M. van der Burg N. Ahmad Aziz Maurits C. Kaptein Martine J.M. Breteler Joris H. Janssen Lisa van Vliet Daniel Winkeler Anneke van Anken Marise J. Kasteleyn Niels H. Chavannes |
author_sort |
Jorien M.M. van der Burg |
title |
Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPD |
title_short |
Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPD |
title_full |
Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPD |
title_fullStr |
Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPD |
title_full_unstemmed |
Long-term effects of telemonitoring on healthcare usage in patients with heart failure or COPD |
title_sort |
long-term effects of telemonitoring on healthcare usage in patients with heart failure or copd |
publisher |
KeAi Communications Co., Ltd. |
series |
Clinical eHealth |
issn |
2588-9141 |
publishDate |
2020-01-01 |
description |
Background: Heart failure and chronic obstructive pulmonary disease (COPD) are leading causes of disability and lead to substantial healthcare costs. The aim of this study was to evaluate the effectiveness of home telemonitoring in reducing healthcare usage and costs in patients with heart failure or COPD. Methods: The study was a retrospective observational study with a follow-up duration of up to 3 years in which for all participants data before and after enrollment in the telemonitoring program was compared. Hundred seventy-seven patients with heart failure (NYHA functional class 3 or 4) and 83 patients with COPD (GOLD stage 3 or 4) enrolled in a home telemonitoring program in addition to receiving usual hospital care. The primary outcome was the number of hospitalizations; the secondary outcomes were total number of hospitalization days and healthcare costs during the follow-up period. Generalized Estimating Equations were applied to account for repeated measurements, adjusting for sex, age and length of follow-up. Results: In heart failure patients, after initiation of home telemonitoring both the number of hospitalizations and the total number of hospitalization days significantly decreased (incidence rate ratio of 0.35 (95% CI: 0.26–0.48) and 0.35 (95% CI: 0.24–0.51), respectively), as did the total healthcare costs (exp(B) = 0.11 (95% CI: 0.08–0.17)), all p < 0.001. In COPD patients neither the number of hospitalizations nor the number of hospitalization days changed compared to the pre-intervention period. However, the healthcare costs were about 54% lower in COPD patients after the start of the telemonitoring intervention (exp(B) = 0.46, 95% CI 0.25–0.84, p = 0.011). Conclusions: Integrated home telemonitoring significantly reduced the number of hospital admissions and days spent in hospital in patients with heart failure, but not in patients with COPD. Importantly, in both patients with heart failure and COPD the intervention substantially reduced the total healthcare costs. |
topic |
Heart failure Chronic Obstructive Pulmonary Disease (COPD) Telemonitoring Remote patient monitoring (RPM) Home monitoring Home telemonitoring |
url |
http://www.sciencedirect.com/science/article/pii/S2588914120300071 |
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