CHI-SHENG HUNGJIUN-YU YUYEN-HUNG LINYING-HSIEN CHENCHING-CHANG HUANGJEN-KUANG LEEChuang P.-Y.YI-LWUN HOMING-FONG CHEN2022-09-202022-09-202016-051438-8871https://www.scopus.com/inward/record.uri?eid=2-s2.0-84973508208&doi=10.2196%2fjmir.5718&partnerID=40&md5=f768c9c048714a50be90cea07abd4e8dhttps://scholars.lib.ntu.edu.tw/handle/123456789/621707Background: We have shown that a fourth-generation telehealth program that analyzes and responds synchronously to data transferred from patients is associated with fewer hospitalizations and lower medical costs. Whether a fourth-generation telehealth program can reduce all-cause mortality has not yet been reported for patients with chronic cardiovascular disease. Objective: We conducted a clinical epidemiology study retrospectively to determine whether a fourth-generation telehealth program can reduce all-cause mortality for patients with chronic cardiovascular disease. Methods: We enrolled 576 patients who had joined a telehealth program and compared them with 1178 control patients. A Cox proportional hazards model was fitted to analyze the impact of risk predictors on all-cause mortality. The model adjusted for age, sex, and chronic comorbidities. Results: There were 53 (9.3%) deaths in the telehealth group and 136 (11.54%) deaths in the control group. We found that the telehealth program violated the proportional hazards assumption by the Schoenfeld residual test. Thus, we fitted a Cox regression model with time-varying covariates. The results showed an estimated hazard ratio (HR) of 0.866 (95% CI 0.837-0.896, P[removed]enAll-cause mortality; Cardiovascular diseases; Elemedicine; Outcome assessment (health care)[SDGs]SDG3journal article10.2196/jmir.5718271774972-s2.0-84973508208