Cost-minimization analysis of a telehomecare program for patients with chronic obstructive pulmonary disease.

A cost-minimization analysis was performed on a telehomecare program for patients with a chronic obstructive pulmonary disease (COPD). The research was quasi-experimental and included a control group. We compared the effects and costs of care provided to a group of 19 patients under a telehomecare program to a comparable group of 10 patients receiving regular home care without telemonitoring. Our results clearly indicate that there were fewer home visits by nurses and hospitalizations for patients in the experimental group. However, these patients made more telephone calls than patients in the control group, although this difference was not statistically significant. Of utmost importance, the cost-minimization analysis yielded positive results. Indeed, telemonitoring over a 6-month period generated $355 in savings per patient, or a net gain of 15% compared to traditional home care. Our study confirms the findings of previous studies that analyzed the efficacy of telemonitoring for patients with COPD. Patients were found to easily accept the idea of using the technology, and the telehomecare program demonstrated significant clinical benefits. Financial advantages of the program could have been more pronounced had it not been for the cost of technology that effectively erased a good portion of the savings.

[1]  Kim Tolley,et al.  An evaluation of the west Surrey telemedicine monitoring project , 2003, Journal of telemedicine and telecare.

[2]  Marshall I Hertz,et al.  Home monitoring for lung transplant candidates. , 2003, Progress in transplantation.

[3]  I. Winblad,et al.  A Cost-Minimization Analysis of Orthopaedic Consultations Using Videoconferencing in Comparison with Conventional Consulting , 2002 .

[4]  Tari Haahtela,et al.  Randomised comparison of guided self management and traditional treatment of asthma over one year , 1996, BMJ.

[5]  I. Aris,et al.  An Internet-based blood pressure monitoring system for patients , 2001, Journal of telemedicine and telecare.

[6]  R. Bayford,et al.  A feasibility study of remote monitoring of asthmatic patients. , 2002, Journal of telemedicine and telecare.

[7]  C. Maiolo,et al.  Home telemonitoring for patients with severe respiratory illness: the Italian experience , 2003, Journal of telemedicine and telecare.

[8]  B. Johnston,et al.  Outcomes of the Kaiser Permanente Tele-Home Health Research Project. , 2000, Archives of family medicine.

[9]  Elizabeth M. Borycki,et al.  Reduction of Hospital Utilization in Patients With Chronic Obstructive Pulmonary Disease: A Disease-Specific Self-management Intervention , 2003 .

[10]  G. Hripcsak,et al.  Internet-based home asthma telemonitoring: can patients handle the technology? , 2000, Chest.

[11]  Charles W Callahan,et al.  An Internet-based store-and-forward video home telehealth system for improving asthma outcomes in children. , 2003, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[12]  L. Boulet,et al.  Compliance with peak expiratory flow monitoring in home management of asthma. , 1998, Chest.