Abstract 11964: A Fourth Generation Telehealth Care Program is Associated With Lower Hospitalization Rate, Duration and Lower Medical Cost
Background: Telehealth management program is a rapid growing field for the care of patients with chronic diseases. The fourth generation of telemedicine involved a synchronous data transfer and fully intergrated remote management systems. The efficacy and cost of the fourth generation of telehealth program has not been proved. We design this study to elucidate the difference in hospitalization and medical cost in adult patients using telehealth care vs usual care.
Methods: We retrospectively analyzed 575 patients who has joined telehealth care program at cardiovascular center of National Taiwan University Hospital, to compare with 1178 patients with matched sex, age and Charlson socre. A subgroup with age over 80 was also analyzed. Telehealth care program included synchronized daily biometric data analysis, symptom reporting, and immediate drug adjustment or medical suggestion from an attending physician. The data of hospitalization, ED visit and medical cost were collected from electrical database at the hospital.
Results: The mean age of study group and control group were 64.6(16.3), 64.5(16.1), respectively. The follow-up-month adjusted ED visit (0.059 vs 0.094, p≤0.001), hospitalization (0.05 vs 0.11, p≤0.001), length of hospitzalization (days, 0.77 vs 1.4, p≤0.001) and ICU admission (0.01 vs 0.036, p≤0.001) were significantly lower in case group. The follow-up-month adjusted total ED (US$21.6 vs 37.6, p≤0.001) and hospitalization (389.7 vs 886, p≤0.001) cost were also significantly lower in the case group. A multivariate linear regression analysis revealed that age, telehealth care and Charlson score were the independent factors for the ED visit, hospitalization, length of hospitalization and ICU admission. A bootstrap resampling method revealed the dominant cost-effectiveness of telehealth care program over usual care. The subgroup analysis in patients over 80 year- old revealed similar beneficial results. (follow-up-month-adjusted length of hospitalization day: 1.76 vs 2.57, p≤0.03; follow-up-length-adjusted hospitzation cost: US$714 vs 1395, p≤0.005).
Conclusion: Our data showed the 4th generation telehealth care program was associated with less admission time and duration as well as lower medical cost.
- © 2013 by American Heart Association, Inc.