Rabbe, Stefan; Blankart, Carl R; Franz, Wolfgang-Michael; Hager, Lutz; Schreyögg, Jonas (2023). Impact of a telemonitoring intervention in patients with chronic heart failure in Germany: A difference-in-difference matching approach using real-world data. Journal of telemedicine and telecare, 29(5), pp. 365-373. Sage 10.1177/1357633X20984024
|
Text
1357633x20984024.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC). Download (487kB) | Preview |
Introduction
The aim of this study was to evaluate the effects of a non-invasive telemonitoring intervention on mortality, healthcare costs, and hospital and pharmaceutical utilisation in patients with chronic heart failure (CHF) of a large statutory health insurer in Germany.
Methods
In a retrospective observational cohort study using real-world data, we assessed differences between 635 patients who received a telemonitoring intervention versus 635 receiving usual care covering 36 months after intervention. We used propensity score matching on a set of 102 parameters collected in the 24-month pre-intervention period to correct for observed differences, as well as difference-in-difference (DiD) estimators to account for unobserved differences. We analysed the effect of the intervention for up to three years on (i) all-cause mortality; (ii) costs (i.e. inpatient stays, ambulatory care, pharmaceuticals, and medical aids and appliances); and (iii) healthcare utilisation (i.e. length and number of hospital stays, number of prescriptions).
Results
DiD estimates suggest lower inpatient costs of the telemonitoring group of up to €1160 (95% confidence interval (CI): –2253 to –69) in year three. Ambulatory care costs increased significantly in all three years up to €316 (95% CI: 1267 to 505) per year. Telemonitoring had a positive effect on survival (hazard ratio = 0.71; 95% CI: 0.51 to 0.99) and increased the number of prescriptions for diuretics. Effects were more prominent for patients with severe CHF.
Discussion
The study suggests that the telemonitoring intervention led to a significant decrease in mortality and a shift in costs from the inpatient to the ambulatory care sector 36 months after intervention.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship > Healthcare Regulation and Management 11 Centers of Competence > KPM Center for Public Management |
UniBE Contributor: |
Blankart, Rudolf |
Subjects: |
300 Social sciences, sociology & anthropology > 350 Public administration & military science |
ISSN: |
1357-633X |
Publisher: |
Sage |
Funders: |
[UNSPECIFIED] IKK Suedwest ; [UNSPECIFIED] SHL Telemedicine |
Language: |
English |
Submitter: |
Carl Rudolf Berchtold Blankart |
Date Deposited: |
04 Oct 2021 12:35 |
Last Modified: |
18 May 2023 00:11 |
Publisher DOI: |
10.1177/1357633X20984024 |
PubMed ID: |
33557666 |
BORIS DOI: |
10.48350/159473 |
URI: |
https://boris.unibe.ch/id/eprint/159473 |
Actions (login required)
 |
Edit item |