Economic outcomes from telecardiology services

Abstract

ABSTRACT Background and Objectives: Owing to the scarcity of health-care financing and the pressure of aging with the associated increased incidence of chronic heart failure, new models of health-care delivery supported by technology solution require a social economic analysis. We aim to assess improvement of Kansas City Living with Cardiomyopathy Questionnaire (KCCQ) score with telehome monitoring in elderly patients affected with Chronic Heart Failure (CHF) and to estimate a probable cost saving for health-care provider and patient, by calculating a probability to reduce fatal events such as mortality and hospitalization associated with improved health status measured with the KCCQ questionnaire. Materials and Methods: An observational quasi-experimental trial was used. Eight patients affected with chronic heart failure aged 85-90 years of age who have been at least three times hospitalized within the last year were recruited for the study. These patients received an educational module to empower their self-management capacity and a medicine kit necessary for telehome monitoring. The KCCQ questionnaire was employed. The KCCQ questionnaire is an independent predictor of health-care resource utilization. The KCCQ score improvement is associated likely with rehospitalization and mortality reduction according to results from previous clinical trial, where KCCQ score has been demonstrated as a strong statistically independent predictor of mortality and rehospitalization after adjustment for other variables. Results: The KCCQ score improved for 15 points from baseline measurement, after 6 months of telehome monitoring. The improvement of KCCQ score of 15 points represents a reduction of probability of hospitalization and mortality for 18% and 16%, respectively. In addition, an individual's cost savings were calculated, using the individual's willingness to pay to avoid fatal event, individual's productivity gain by avoiding a travel to remote hospital facilities, and an improved probability of positive event with telehome monitoring. Conclusion: Analysis demonstrated a probability for an important economical saving with the use of telehome monitoring for the provider and patient. We can conclude that telehome monitoring represents an innovative service that provides clinical and economical value addition to the patient, health-care system, and society.