Department of Health Management and Policy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd EAD 709B, Fort Worth, TX 76107, USA.
Am J Manag Care. 2011 Jun 1;17(6 Spec No.):e224-30.
To examine the effect of an integrated, clinician-focused telehealth monitoring system on the probability of hospitalization within the first 30-day episode of home healthcare.
Retrospective, nonexperimental design.
The study sample includes 2009 data from 5873 Medicare beneficiaries receiving home healthcare services through a network of community-based home health agencies operating in Texas and Louisiana. Propensity-score matching was used to control for selection bias. Logistic regression and postestimation parameter simulation were used to assess how the use of an integrated, clinician-focused telehealth monitoring system might affect the probability of hospitalization during the first 30-day episode of home healthcare.
The 30-day probability of hospitalization for telehealth and non-telehealth patients was 10.3% and 17.1%, respectively. Patients in the telehealth group had a 7-percentage-point (95% confidence interval 4.2, 9.4) lower probability of hospitalization within the first 30-day episode of home healthcare than those in the non-telehealth group.
The use of an integrated, clinician focused telehealth monitoring system can substantially reduce the 30-day probability of hospitalization for home healthcare patients. Telehealth monitoring systems that integrate skilled clinicians can lead to substantial hospitalization-related cost savings.
考察整合型、以临床医生为重点的远程医疗监测系统对家庭医疗保健首个 30 天疗程内住院概率的影响。
回顾性、非实验性设计。
研究样本包括来自德克萨斯州和路易斯安那州社区为基础的家庭健康机构网络中接受家庭医疗服务的 5873 名医疗保险受益人的 2009 年数据。采用倾向评分匹配来控制选择偏差。采用逻辑回归和后估计参数模拟来评估整合型、以临床医生为重点的远程医疗监测系统的使用如何影响家庭医疗保健首个 30 天疗程内的住院概率。
远程医疗和非远程医疗患者的 30 天住院概率分别为 10.3%和 17.1%。与非远程医疗组相比，远程医疗组患者在家庭医疗保健首个 30 天疗程内的住院概率低 7 个百分点（95%置信区间为 4.2，9.4）。
使用整合型、以临床医生为重点的远程医疗监测系统可显著降低家庭医疗保健患者的 30 天住院概率。整合了熟练临床医生的远程医疗监测系统可带来可观的与住院相关的成本节约。
