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Can a telemonitoring system lead to decreased hospitalization in elderly patients?
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.
Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.
2019 (English)In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, article id UNSP 1357633X19858178Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction Growing populations of elderly patients with chronic obstructive pulmonary disease (COPD) or heart failure (HF) require more healthcare. A four-year telehealth intervention - the Health Diary system based on digital pen technology - was implemented. We hypothesized that study patients with advanced COPD or HF would have lower rates of hospitalization when using the Health Diary. The aim was to investigate the effects of the intervention on healthcare costs and the number of hospitalizations, as well as other care required in COPD and HF patients. Methods Patients were introduced to the telemonitoring system which was supervised by a specialized hospital-based home care (HBHC) unit. Staff associated with this unit were responsible for the healthcare provided. The study included patients with COPD or HF, aged amp;gt;= 65 years who were frequently hospitalized due to exacerbations - at least two inpatient episodes within the last 12 months. Observed number of hospitalizations and total healthcare costs were compared with the expected values, which were calculated using the generalized estimating equations (GEE) method. Results A total of 36 COPD and 58 HF patients with advanced stages of disease were included. The number of hospitalizations was significantly reduced for both HF and COPD patients participating in telemonitoring. Accordingly, hospitalization costs were significantly reduced for both groups, but the total healthcare cost was not significantly different from the expected costs. Conclusion A telemonitoring system, the Health Diary, combined with a specialized HBHC unit significantly decreases the need for hospital care in elderly patients with advanced HF or COPD without increasing total healthcare costs.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2019. article id UNSP 1357633X19858178
Keywords [en]
Home telecare; telemedicine; telecare; telehealth; digital pen; heart failure; chronic obstructive pulmonary disease
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-159582DOI: 10.1177/1357633X19858178ISI: 000477087500001PubMedID: 31291794OAI: oai:DiVA.org:liu-159582DiVA, id: diva2:1342206
Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-13

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Lyth, JohanLind, LeiliPersson, Hans L.Wiréhn, Ann-Britt
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Division of Health Care AnalysisFaculty of Medicine and Health SciencesResearch and Development UnitDivision of Biomedical EngineeringFaculty of Science & EngineeringDepartment of Medical and Health SciencesDepartment of Respiratory Medicine
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Journal of Telemedicine and Telecare
Health Care Service and Management, Health Policy and Services and Health Economy

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