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Cost analysis of home monitoring in lung transplant recipients

Published online by Cambridge University Press:  01 April 2007

Terrence J. Adam ,
Stanley M. Finkelstein ,
Stephen T. Parente  and
Marshall I. Hertz
Terrence J. Adam
Affiliation:
Mayo Clinic Arizona
Stanley M. Finkelstein
Affiliation:
University of Minnesota
Stephen T. Parente
Affiliation:
University of Minnesota
Marshall I. Hertz
Affiliation:
University of Minnesota
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Abstract

Objectives: The University of Minnesota has maintained a home monitoring program for over 10 years for lung and heart–lung transplant patients. A cost analysis was completed to assess the impact of home monitoring on the cost of post-transplant medical care.

Methods: Clinical information gathered with the monitoring system includes spirometry, vital signs, and symptom data. To estimate the impact of this system on medical costs, we completed a retrospective analysis of the effects of home monitoring on the cost of post-lung transplant medical care. The cost analysis used multivariate linear regression with inpatient, outpatient, and total medical care costs as the dependent variables. The independent variables for the regression include home monitoring adherence, underlying disease, ambulatory diagnostic group mapping variables, transplant type, and patient demographics.

Results: The multivariate regression of the overall cost results predicts a 52.4 percent reduction in total costs with 100 percent patient adherence; this rate includes a 72.24 percent reduction in inpatient costs and a 46.6 percent increase in outpatient costs. The actual first year average patient adherence was 74 percent.

Conclusions: Adherence to home monitoring increases outpatient costs and reduces inpatient costs and provides an overall cost savings. The break-even point for patient adherence was 25.28 percent, where the net savings covered the cost of home monitoring. This is well within the actual first year adherence rates (74 percent) for subjects in the lung transplant home monitoring program, providing a net savings with adherence to home monitoring.

Keywords

Lung transplantationHome monitoringCost analysis
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 2 , April 2007 , pp. 216 - 222
Copyright
Copyright © Cambridge University Press 2007

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