1 Social Involvement of Critical and Emergency Medicine, CTS-609 Research Group, Hospital de Poniente, Almeria, Spain.
2 Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø. Norway.
J Telemed Telecare. 2019 May;25(4):204-212. doi: 10.1177/1357633X18767184. Epub 2018 Apr 6.
Few studies have confirmed the cost-saving of telemonitoring of users with pacemakers (PMs). The purpose of this controlled, non-randomised, non-masked clinical trial was to perform an economic assessment of telemonitoring (TM) of users with PMs and check whether TM offers a cost-utility alternative to conventional follow-up in hospital.
Eighty-two patients implanted with an internet-based transmission PM were selected to receive either conventional follow-up in hospital ( n = 52) or TM ( n = 30) from their homes. The data were collected during 12 months while patients were being monitored. The economic assessment of the PONIENTE study was performed as per the perspectives of National Health Service (NHS) and patients. A cost-utility analysis was conducted to measure whether the TM of patients with PMs is cost-effective in terms of costs per gained quality-adjusted life years (QALYs).
There was a significant cost-saving for participants in the TM group in comparison with the participants in the conventional follow-up group. From the NHS's perspective, the patients in the TM group gained 0.09 QALYs more than the patients in the conventional follow-up group over 12 months, with a cost saving of 57.64% (€46.51 versus €109.79, respectively; p < 0.001) per participant per year. In-office visits were reduced by 52.49% in the TM group. The costs related to the patient perspective were lower in the TM group than in the conventional follow-up group (€31.82 versus €73.48, respectively; p < 0.005). The costs per QALY were 61.68% higher in the in-office monitoring group.
The cost-utility analysis performed in the PONIENTE study showed that the TM of users with PMs appears to be a significant cost-effective alternative to conventional follow-up in hospital.
很少有研究证实远程监测起搏器（PM）使用者的成本节约。本对照、非随机、非盲临床试验的目的是对 PM 使用者的远程监测（TM）进行经济评估，并检查 TM 是否为传统医院随访提供了一种具有成本效益的替代方案。
选择 82 名植入基于互联网传输 PM 的患者，分别接受传统医院随访（n=52）或家庭 TM（n=30）。在监测期间收集了 12 个月的数据。PONIENTE 研究的经济评估是按照国家卫生服务（NHS）和患者的观点进行的。进行成本效用分析，以衡量 PM 患者的 TM 是否在成本效益方面具有成本效益，即每获得一个质量调整生命年（QALY）的成本。
与传统随访组相比，TM 组的参与者有显著的成本节约。从 NHS 的角度来看，TM 组的患者在 12 个月内比传统随访组多获得 0.09 个 QALY，每个患者每年的成本节约为 57.64%（€46.51 与€109.79 相比；p<0.001）。TM 组的门诊就诊次数减少了 52.49%。TM 组的患者相关成本低于传统随访组（€31.82 与€73.48 相比；p<0.005）。TM 组的每 QALY 成本比门诊监测组高 61.68%。
PONIENTE 研究中的成本效用分析表明，PM 使用者的 TM 似乎是传统医院随访的一种具有显著成本效益的替代方案。
