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远程患者监测项目对 2 型糖尿病出院患者的成本分析。

Cost analysis of a remote patient monitoring programme for post-discharge patients with type 2 diabetes.

机构信息

Center for Reducing Health Disparities, University of Nebraska Medical Center, USA.

Department of Health Promotion, University of Nebraska Medical Center, USA.

出版信息

J Telemed Telecare. 2023 Jul;29(6):417-425. doi: 10.1177/1357633X20985393. Epub 2021 Jan 26.

Abstract

INTRODUCTION

Assessing costs of an evidence-based health promotion programme is crucial to understand the economic feasibility of adopting or sustaining the programme. This study conducted a cost analysis of a remote patient monitoring (RPM) programme to enhance the post-discharge management of type 2 diabetes.

METHODS

Using retrospective data collected during RPM implementation from September 2014 to February 2018, we estimated the costs of implementing an RPM in the primary care setting. Measures included total and average annual costs, costs per participant who was enrolled or completed the programme, and costs per person-day. We further conducted sensitivity and scenario analyses to examine variations in estimated programme costs associated with varying programme efficiencies and alternative personnel compositions of the RPM team.

RESULTS

The total RPM implementation costs were estimated at US$4,374,544 with an average annual programme costs of US$1,249,870, which translated to US$3207 per participant ( = 1364) completing the three-month programme. The per person-day cost was averaged at US$24 (182,932 person-days). Sensitivity and scenario analyses results indicate that the sustainment costs were approximately US$1.6 million annually and the per-person-day costs were between US$21 and US$29 with each nurse coach on average serving a panel of 62-93 patients.

CONCLUSION

The implementation and sustainment costs of an RPM programme, estimated under various assumptions of programme efficiency and care team compositions, as exemplified in this study, will help healthcare organizations make informed decisions in budgeting for and sustaining telehealth programmes to enhance diabetes management.

摘要

介绍

评估基于证据的健康促进计划的成本对于了解采用或维持该计划的经济可行性至关重要。本研究对远程患者监测(RPM)计划进行了成本分析,以加强 2 型糖尿病的出院后管理。

方法

使用 2014 年 9 月至 2018 年 2 月实施 RPM 期间收集的回顾性数据,我们估算了在初级保健环境中实施 RPM 的成本。措施包括总实施成本和年均成本、参加或完成该计划的每位参与者的成本以及人均日成本。我们进一步进行了敏感性和情景分析,以检查与不同计划效率和 RPM 团队替代人员组成相关的估计计划成本的变化。

结果

RPM 实施总成本估计为 437.4544 万美元,年均计划成本为 124.987 万美元,这意味着完成三个月计划的每位参与者的成本为 3207 美元( = 1364 美元)。人均日成本平均为 24 美元(182932 人日)。敏感性和情景分析结果表明,维持成本约为每年 160 万美元,人均日成本在 21 美元至 29 美元之间,每位护士教练平均服务 62-93 名患者。

结论

在各种计划效率和护理团队组成假设下估算的 RPM 计划的实施和维持成本,如本研究所示,将帮助医疗机构在预算和维持远程医疗计划以加强糖尿病管理方面做出明智的决策。

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