Moreno Lorenzo, Dale Stacy B, Chen Arnold Y, Magee Carol A
Mathematica Policy Research, Inc., Princeton, New Jersey, USA.
Diabetes Care. 2009 Jul;32(7):1202-4. doi: 10.2337/dc09-0094. Epub 2009 Apr 14.
To estimate the impacts on Medicare costs of providing a particular type of home telemedicine to eligible Medicare beneficiaries with type 2 diabetes.
Two cohorts of beneficiaries (n = 1,665 and 504, respectively) living in two medically underserved areas of New York between 2000 and 2007 were randomized to intensive nurse case management via televisits or usual care. Medicare service use and costs covering a 6-year follow-up period were drawn from claims data. Impacts were estimated using regression analyses.
Informatics for Diabetes Education and Telemedicine (IDEATel) did not reduce Medicare costs in either site. Total costs were between 71 and 116% higher for the treatment group than for the control group.
Although IDEATel had modest effects on clinical outcomes (reported elsewhere), it did not reduce Medicare use or costs for health services. The intervention's costs were excessive (over $8,000 per person per year) compared with programs with similar-sized clinical impacts.
评估为符合条件的患有2型糖尿病的医疗保险受益人提供特定类型的家庭远程医疗对医疗保险费用的影响。
2000年至2007年间，居住在纽约两个医疗服务不足地区的两组受益人（分别为n = 1665人和504人）被随机分配接受通过远程问诊进行的强化护士病例管理或常规护理。6年随访期内的医疗保险服务使用情况和费用来自索赔数据。使用回归分析评估影响。
糖尿病教育与远程医疗信息系统（IDEATel）在两个地点均未降低医疗保险费用。治疗组的总成本比对照组高71%至116%。
尽管IDEATel对临床结果有适度影响（其他地方有报道），但它并未减少医疗保险的使用或医疗服务费用。与具有类似规模临床影响的项目相比，该干预措施的成本过高（每人每年超过8000美元）。
