Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-26T11:44:52.688Z Has data issue: false hasContentIssue false
  • English
  • Français

HOME TELEMONITORING FOR CHRONIC DISEASE MANAGEMENT: AN ECONOMIC ASSESSMENT

Published online by Cambridge University Press:  20 March 2013

Guy Paré ,
Placide Poba-Nzaou  and
Claude Sicotte
Guy Paré
Affiliation:
Canada Research Chair in Information Technology in Health Care, HEC Montréal
Placide Poba-Nzaou
Affiliation:
Faculty of Management, Université du Québec à Montréal
Claude Sicotte
Affiliation:
Health Administration Department, Faculty of Medicine, Université de Montréal
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: There have been very few assessments of the economics of home telemonitoring, and the quality of evidence has often been weakened by methodological flaws. This has made it difficult to compare telehomecare with traditional home care for the chronic diseases studied. This economic analysis is an attempt to address this gap in the literature.

Methods: We have analyzed the consumption of healthcare services by 95 patients with various chronic diseases over a 21-month period, that is, 12 months before, 4 months during home telemonitoring use, and over 5 months after withdraw of the technology.

Results: Our findings indicate significant benefits to the home telemonitoring program as evidenced by large reductions in number of hospitalizations, length of average hospital stay, and, to a lesser extent, number of emergency room visits. Contrary to expectations, however, the number of home visits by nurses increased both during and after the telemonitoring intervention. In terms of the financial analysis, the telehomecare program resulted in significant savings: the equivalent of over CAD1,557 per patient as calculated on an annualized basis. This represents a net gain of 41 percent as compared to traditional home care.

Conclusions: While the present economic analysis led to positive results, additional assessments should be conducted to confirm the cost-effectiveness of this mode of care delivery.

Keywords

Home telemonitoringtelehomecareCost minimization analysis; Chronic disease management
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 2 , April 2013 , pp. 155 - 161
Copyright
Copyright © Cambridge University Press 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.World Health Organization. Home care in Europe. 2008. http://www.euro.who.int/__data/assets/pdf_file/0005/96467/ E91884.pdf (accessed June 29, 2012).Google Scholar
2.Quebec Health & Social Services Ministry. Chez soi: le premier choix. La politique de soutien à domicile. 2003. http://publications.msss.gouv.qc.ca/acrobat/f/documentation/2002/02-704-01.pdf (accessed June 29, 2012).Google Scholar
3.Canadian Home Care Association. Home is best™: Developing an integrated primary and home & community care system. 2012. http://www.cdnhomecare.ca/media.php?mid=2906 (accessed June 29, 2012).Google Scholar
4.Canada Health Infoway. Toward critical mass: Moving from availability to adoption (title of 2010-2011 annual report). 2011. https://www.infoway-inforoute.ca/index.php/resources/infoway-corporate/ annual-reports (accessed June 29, 2012).Google Scholar
5.Canada Health Infoway. Telehealth benefits and adoption: Connecting people and providers across Canada. 2011. https://www.infoway-inforoute.ca/index.php/resources/reports/benefits-evaluation?start=5 (accessed June 29, 2012).Google Scholar
6.Roine, R, Ohinmaa, A, Hailey, D. Assessing telemedicine: A systematic review of the literature. Can Med Assoc J. 2001;165:765–771.Google ScholarPubMed
7.Paré, G, Moqadem, K, Pineau, G, St-Hilaire, C. Clinical effectiveness of home telemonitoring programs in the context of diabetes, asthma, heart failure and hypertension: A systematic review. J Med Internet Res. 2010;12:e21.CrossRefGoogle Scholar
8.Dang, S, Dimmick, S, Kelkar, G. Evaluating the evidence base for the use of home telehealth remote monitoring in elderly with heart failure. Telemed J E Health. 2009;15:783–796.CrossRefGoogle ScholarPubMed
9.Polinesa, J, Tran, K, Cimon, K, et al.Home telehealth for diabetes management: A systematic review and meta-analysis. Diabetes Obes Metab. 2009;11:913–930.Google Scholar
10.Paré, G, Jaana, M, Sicotte, C. Systematic review of home telemonitoring for chronic diseases: The evidence base. J Am Med Inform Assoc. 2007;14:269–277.CrossRefGoogle ScholarPubMed
11.Maric, B, Kaan, A, Ignaszewski, A, Lear, SA. A systematic review of telemonitoring technologies in heart failure. Eur J Heart Fail. 2009;11:506–517.CrossRefGoogle ScholarPubMed
12.Clarke, M, Shah, A, Sharma, U. Systematic review of studies on telemonitoring of patients with congestive heart failure: A meta-analysis. J Telemed Telecare. 2011;17:7–14.CrossRefGoogle ScholarPubMed
13.Seto, E. Cost comparison between telemonitoring and usual care of heart failure: A systematic review. Telemed J E Health. 2008;14:679–686.CrossRefGoogle ScholarPubMed
14.Polinesa, J, Coyle, D, Coyle, K, McGill, S. Home telehealth for chronic disease management: Systematic review and an analysis of economic evaluations. Int J Technol Assess Health Care. 2009;25:339–349.Google Scholar
15.Klersy, C, De Silvestri, A, Gabutti, G, et al.A meta-analysis of remote monitoring of heart failure patients. J Am Coll Cardiol. 2009;54:1683–1694.CrossRefGoogle ScholarPubMed
16.Polinesa, J, Tran, K, Cimon, K, et al.Home telemonitoring for congestive heart failure: A systematic review and meta-analysis. J Telemed Telecare. 2010;16:68–76.Google Scholar
17.Polinesa, J, Tran, K, Cimon, K, et al.Home telehealth for chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Telemed Telecare. 2010;16:120–127.Google Scholar
18.Miller, RB, Hollist, CS. Attrition bias. In: Salkind N, ed. Encyclopedia of measurement and statistics. Thousand Oaks: Sage Reference; 2007:57–60.Google Scholar
19.Drummond, MF, O'Brien, B, Stoddart, GL, Torrance, GW. Methods for the economic evaluation of health care programmes. 2nd ed.Oxford: Oxford Medical Publications; 1997.Google Scholar
20.Johnson, B, Wheeler, L, Deuser, J, Sousa, KH. Outcomes of the Kaiser Permanente telehome health research project. Arch Fam Med. 2009;9:40–45.CrossRefGoogle Scholar
21.Jerant, AF, Azari, R, Nesbitt, TS. Reducing the cost of frequent hospital admissions for congestive heart failure. Med Care. 2001;39:1234–1245.CrossRefGoogle ScholarPubMed
22.Lehmann, CA, Mintz, N, Giacini, JM. Impact of telehealth on healthcare utilization by congestive heart failure patients. Dis Manage Health Outcomes, 2006;14:163–169.CrossRefGoogle Scholar
Supplementary material: File

Paré et al supplementary material

Supplementary table 1

Download Paré et al supplementary material(File)
File 54.3 KB
Supplementary material: File

Paré et al supplementary material

Supplementary table2

Download Paré et al supplementary material(File)
File 33.8 KB