TY - JOUR
T1 - Cost comparison between home telemonitoring and usual care of older adults
T2 - A randomized trial (Tele-ERA)
AU - Upatising, Benjavan
AU - Wood, Douglas L.
AU - Kremers, Walter K.
AU - Christ, Sharon L.
AU - Yih, Yuehwern
AU - Hanson, Gregory J.
AU - Takahashi, Paul Y.
N1 - Publisher Copyright:
© 2015, Mary Ann Liebert, Inc.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background: From 1992 to 2008, older adults in the United States incurred more healthcare expense per capita than any other age group. Home telemonitoring has emerged as a potential solution to reduce these costs, but evidence is mixed. The primary aim of the study was to evaluate whether the mean difference in total direct medical cost consequence between older adults receiving additional home telemonitoring care (TELE) (n=102) and those receiving usual medical care (UC) (n=103) were significant. Inpatient, outpatient, emergency department, decedents, survivors, and 30-day readmission costs were evaluated as secondary aim. Materials and Methods: Multivariate generalized linear models (GLMs) and parametric bootstrapping method were used to model cost and to determine significance of the cost differences. We also compared the differences in arithmetic mean costs. Results: From the conditional GLMs, the estimated mean cost differences (TELE versus UC) for total, inpatient, outpatient, and ED were -$9,537 (p=0.068), -$8,482 (p =0.098), -$1,160 (p=0.177), and $106 (p=0.619), respectively. Mean postenrollment cost was 11% lower than the prior year for TELE versus 22% higher for UC. The ratio of mean cost for decedents to survivors was 2.1:1 (TELE) versus 12.7:1 (UC). Conclusions: There were no significant differences in the mean total cost between the two treatment groups. The TELE group had less variability in cost of care, lower decedents to survivors cost ratio, and lower total 30-day readmission cost than the UC group.
AB - Background: From 1992 to 2008, older adults in the United States incurred more healthcare expense per capita than any other age group. Home telemonitoring has emerged as a potential solution to reduce these costs, but evidence is mixed. The primary aim of the study was to evaluate whether the mean difference in total direct medical cost consequence between older adults receiving additional home telemonitoring care (TELE) (n=102) and those receiving usual medical care (UC) (n=103) were significant. Inpatient, outpatient, emergency department, decedents, survivors, and 30-day readmission costs were evaluated as secondary aim. Materials and Methods: Multivariate generalized linear models (GLMs) and parametric bootstrapping method were used to model cost and to determine significance of the cost differences. We also compared the differences in arithmetic mean costs. Results: From the conditional GLMs, the estimated mean cost differences (TELE versus UC) for total, inpatient, outpatient, and ED were -$9,537 (p=0.068), -$8,482 (p =0.098), -$1,160 (p=0.177), and $106 (p=0.619), respectively. Mean postenrollment cost was 11% lower than the prior year for TELE versus 22% higher for UC. The ratio of mean cost for decedents to survivors was 2.1:1 (TELE) versus 12.7:1 (UC). Conclusions: There were no significant differences in the mean total cost between the two treatment groups. The TELE group had less variability in cost of care, lower decedents to survivors cost ratio, and lower total 30-day readmission cost than the UC group.
KW - 30-day readmission
KW - Cost comparison
KW - home telemonitoring
KW - older adult
KW - telemedicine
UR - http://www.scopus.com/inward/record.url?scp=84921454055&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84921454055&partnerID=8YFLogxK
U2 - 10.1089/tmj.2014.0021
DO - 10.1089/tmj.2014.0021
M3 - Article
C2 - 25453392
AN - SCOPUS:84921454055
SN - 1530-5627
VL - 21
SP - 3
EP - 8
JO - Telemedicine and e-Health
JF - Telemedicine and e-Health
IS - 1
ER -