Healthcare Management, University Erlangen-Nuremberg, Nuremberg, Germany.
Telemed J E Health. 2012 Apr;18(3):198-204. doi: 10.1089/tmj.2011.0134. Epub 2012 Feb 22.
A health economic analysis was conducted to evaluate the program "Telemedicine for the Heart," which the German Foundation for the Chronically Ill organizes for the Techniker Krankenkasse, one of the biggest German statutory health insurance funds. The program consists of nurse-calls to motivate patients to perform regular self-measurements (blood pressure, pulse, weight) with either their own or telemedical measuring devices provided by the program. In the case of measured values outside of set limits, calls to treating physicians were placed to allow for the initiation of therapy adjustments where applicable.
To evaluate the program, a retrospective matched-pairs analysis was performed. Program participants (n=281) and regularly insured patients (n=843) were matched for demographics and morbidity status and compared according to their use of resources.
Significant cost differences in favor of the study group of up to 25% in relation to total costs could be detected, particularly in the group of New York Heart Association (NYHA) classification II patients (persons with mild symptoms and slight limitation according to the NYHA classification for the extent of heart failure). In the more severe NYHA stages III and IV the cost relation differed and showed a slight cost disadvantage for the program group. Mortality was 35.1% lower in the program group than in the control group. Quality of life measures were almost constant over the observation time, compatible with a positive impact of the program on the highly impaired patient group.
The findings suggest that, besides a reduction of costs, by participating in "Telemedicine for the Heart" patients with chronic heart failure experienced a reduced number of hospital stays, optimized medical therapy, better quality of life, and reduced mortality.
对德国慢性病基金会为德国最大的法定健康保险基金之一——德国技术人员健康保险协会组织的“远程心脏医疗”项目进行健康经济分析。该项目包括护士来电，以激励患者定期使用自己或项目提供的远程医疗测量设备进行自我测量（血压、脉搏、体重）。如果测量值超出设定范围，将致电主治医生，以便在适用的情况下调整治疗方案。
为了评估该项目，我们进行了回顾性配对分析。将项目参与者（n=281）和常规参保患者（n=843）按照人口统计学和发病情况进行配对，并根据他们的资源使用情况进行比较。
与总费用相比，研究组的成本差异显著，高达 25%，尤其是在纽约心脏协会（NYHA）分级 II 患者组（NYHA 分级为心力衰竭程度的轻度症状和轻度限制）中。在更严重的 NYHA 分级 III 和 IV 中，成本关系不同，项目组显示出轻微的成本劣势。与对照组相比，项目组的死亡率低 35.1%。在观察期间，生活质量指标几乎保持不变，这与该项目对高受损患者群体的积极影响一致。
研究结果表明，除了降低成本外，参加“远程心脏医疗”项目的慢性心力衰竭患者还经历了住院次数减少、优化了医疗治疗、提高了生活质量和降低了死亡率。
