https://scholars.lib.ntu.edu.tw/handle/123456789/523139
標題: | Assessment of the cost-effectiveness and clinical outcomes of a fourth-generation synchronous telehealth program for the management of chronic cardiovascular disease | 作者: | YI-LWUN HO JIUN-YU YU YEN-HUNG LIN YING-HSIEN CHEN CHING-CHANG HUANG Hsu, Tse-Pin Chuang, Pao-Yu CHI-SHENG HUNG MING-FONG CHEN |
公開日期: | 2014 | 出版社: | Journal of Medical Internet Research | 卷: | 16 | 期: | 6 | 來源出版物: | Journal of Medical Internet Research | 摘要: | Telehealth programs are a growing field in the care of patients. The evolution of information technology has resulted in telehealth becoming a fourth-generation synchronous program. However, long-term outcomes and cost-effectiveness analysis of fourth-generation telehealth programs have not been reported in patients with chronic cardiovascular diseases. Objective: We conducted this study to assess the clinical outcomes and cost-effectiveness of a fourth-generation synchronous telehealth program for patients with chronic cardiovascular diseases. Methods: We retrospectively analyzed 575 patients who had joined a telehealth program and compared them with 1178 patients matched for sex, age, and Charlson comorbidity index. The program included: (1) instant transmission of biometric data, (2) daily telephone interview, and (3) continuous decision-making support. Data on hospitalization, emergency department (ED) visits, and medical costs were collected from the hospital's database and were adjusted to the follow-up months. Results: The mean age was 64.5 years (SD 16.0). The mean number of monthly ED visits (mean 0.06 SD 0.13 vs mean 0.09 SD 0.23, P<.001), hospitalizations (mean 0.05 SD 0.12 vs mean 0.11 SD 0.21, P<.001), length of hospitalization (mean 0.77 days SD 2.78 vs mean 1.4 SD 3.6, P<.001), and intensive care unit admissions (mean 0.01 SD 0.07 vs mean 0.036 SD 0.14, P<.001) were lower in the telehealth group. The monthly mean costs of ED visits (mean US20.90 SD 66.60 vs mean US37.30 SD 126.20, P<.001), hospitalizations (mean US386.30 SD 1424.30 vs mean US878.20 SD 2697.20, P<.001), and all medical costs (mean US587.60 SD 1497.80 vs mean US1163.60 SD 3036.60, P<.001) were lower in the telehealth group. The intervention costs per patient were US224.80 per month. Multivariate analyses revealed that age, telehealth care, and Charlson index were the independent factors for ED visits, hospitalizations, and length of hospitalization. A bootstrap method revealed the dominant cost-effectiveness of telehealth care over usual care. Conclusions: Better cost-effectiveness and clinical outcomes were noted with the use of a fourth-generation synchronous telehealth program in patients with chronic cardiovascular diseases. The intervention costs of this new generation of telehealth program do not increase the total costs for patient care. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84906215816&doi=10.2196%2fjmir.3346&partnerID=40&md5=00ac9831df8f3097d8641bd7bc056c08 https://scholars.lib.ntu.edu.tw/handle/123456789/523139 |
ISSN: | 1438-8871 | DOI: | 10.2196/jmir.3346 | SDG/關鍵字: | adult; aged; Cardiovascular Diseases; chronic disease; cost benefit analysis; disease management; economics; emergency health service; female; health care cost; hospitalization; human; male; middle aged; procedures; retrospective study; statistics and numerical data; telemedicine; utilization; Adult; Aged; Cardiovascular Diseases; Chronic Disease; Cost-Benefit Analysis; Disease Management; Emergency Service, Hospital; Female; Health Care Costs; Hospitalization; Humans; Male; Middle Aged; Retrospective Studies; Telemedicine |
顯示於: | 醫學系 |
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