JMIR Publications

ABSTRACT

Background:

Many chronic heart failure (HF) patients experience a reduced health status leading to readmission after hospitalization despite receiving conventional care. Telemonitoring approaches aim to improve the early detection of HF decompensations and prevent readmissions. However, knowledge about the impact of telemonitoring on preventing readmissions and related costs remains scarce.

Objective:

This study assessed the effectiveness of adding a telemonitoring solution (TMS) to the standard of care (SOC), for prevention of hospitalization and related costs in HF patients in Finland.

Methods:

A non-randomized pre-post TMS study was performed, to estimate healthcare costs and resource utilization during six months on SOC followed by six months on SOC with a novel TMS. The TMS consisted of a digital platform for patient-reported symptoms and daily weight and blood pressure measurements, automatically generated alerts triggering phone calls with secondary care nurses, and rapid response to alerts by treating physicians. MS data was linked to patient register data on primary care, secondary care, and hospitalization. The patient register of the Southern Savonia Social and Health Care Authority (Essote) was used. Eligible patients had at least one hospital admission within the last 12 months and self-reported New York Heart Association (NYHA) class II-IV from the central hospital in the Southern Savonia region.

Results:

From 50 recruited HF patients, 43 patients completed the study and were included in the analysis. The hospitalization related cost decreased (49%, p=0.03) from €2 189 (95% confidence interval [CI]: €1 384 to €2 994) during SOC to €1 114 (95% CI: €425 to €1 803) during TMS. The number of patients with at least one hospitalization due to HF was reduced by 70% (p=0.002) from 20 patients during SOC (47%) to 6 patients in TMS (14%). The estimated mean total healthcare cost per patient was €3 124 (95% CI: €2 212 to €4 036) during SOC and €2 104 (95 % CI: €1 313 to €2 895) during TMS, resulting in a 33% reduction (p=0.07) in costs with TMS.

Conclusions:

The results suggest that the telemonitoring solution can reduce hospital-related costs in HF patients with a recent prior hospital admission.