Roberts Walter, Lyson Helena, Speer Clint, Tovar Elena, Paz Edo, Zimlichman Eyal
Hello Heart, Inc, Menlo Park, CA, USA.
Hello Heart, Inc, Menlo Park, CA, USA.
Value Health. 2025 Feb 13. doi: 10.1016/j.jval.2025.01.025.
This study evaluated the impact of a mobile health (mHealth) cardiovascular disease (CVD) self-management program on medical spending, healthcare utilization, and clinical outcomes.
We conducted a retrospective cohort, pre-post observational analysis of medical claims data from February 2018 to September 2023. Participants enrolled in the mHealth CVD self-management program were compared with matched nonparticipants to assess changes in medical spending and utilization, using a difference-in-differences (DiD) approach. Moderation analyses tested whether the effect of participation on medical costs differed according to participants' demographic and employer characteristics. Linear mixed models were also used to evaluate changes in participant blood pressure.
There were 7112 participants and an equal number of matched nonparticipants from 14 employers included in the cost-savings analysis. Participation in the mHealth CVD self-management program was associated with an annualized per member savings of $1709 as compared with matched nonparticipants. Although savings were consistent across participant sex and employer type, older participants experienced greater savings. Program participation was associated with fewer inpatient hospital days and increased primary care utilization after enrollment. Program participants experienced significant reductions in blood pressure, with the largest reductions seen among those with stage 2 hypertension at baseline.
Participation in an mHealth CVD self-management program was associated with significant cost savings and clinical improvements across diverse populations, highlighting its effectiveness as a cost-efficient tool for managing CVD and improving health outcomes. Further research is needed to explore the long-term benefits and cost-effectiveness of mHealth programs to support broader adoption.
本研究评估了移动健康(mHealth)心血管疾病(CVD)自我管理项目对医疗支出、医疗保健利用和临床结局的影响。
我们对2018年2月至2023年9月的医疗理赔数据进行了回顾性队列前后观察分析。将参加mHealth CVD自我管理项目的参与者与匹配的未参与者进行比较,采用差异-in-差异(DiD)方法评估医疗支出和利用的变化。调节分析测试了参与对医疗成本的影响是否因参与者的人口统计学和雇主特征而异。线性混合模型也用于评估参与者血压的变化。
成本节约分析纳入了来自14个雇主的7112名参与者和数量相等的匹配未参与者。与匹配的未参与者相比,参加mHealth CVD自我管理项目的参与者年化人均节省1709美元。尽管不同性别和雇主类型的参与者节省情况一致,但年龄较大的参与者节省更多。项目参与与住院天数减少和入组后初级保健利用率增加相关。项目参与者的血压显著降低,基线时患有2期高血压的参与者降幅最大。
参与mHealth CVD自我管理项目与不同人群的显著成本节约和临床改善相关,凸显了其作为管理CVD和改善健康结局的经济高效工具的有效性。需要进一步研究探索mHealth项目的长期益处和成本效益,以支持更广泛的采用。