Remote Patient Monitoring System for Polypathological Older Adults at High Risk for Hospitalization: Retrospective Cohort Study.

BACKGROUND

Health care systems are increasingly facing challenges posed by the aging of populations. In particular, hospitalization, both initial and subsequent, is often observed among older adult patients. However, research suggests that nearly 23% of all hospitalizations could be avoided. In this perspective, remote patient monitoring (RPM) systems are emerging as a promising solution, enabling professionals to detect and manage patient complexities early within home-based care settings.

OBJECTIVE

This study aims to provide additional analyses regarding the impact of the EPOCA RPM system for polypathological older adult patients on the total number of unplanned hospitalization days and admissions, as well as emergency department (ED) visits. In a prior study, we evaluated the impact when the operator of the RPM system is a geriatrician. In this study, we assess the impact when the general practitioner is the operator.

METHODS

We used a retrospective, before-and-after cohort design. Polypathological older adult patients aged 70 and older, who benefited from the EPOCA RPM system for at least 1 year (between February 2022 and August 2024), were included in the analysis. We compared the outcomes between the previous year (Y-1) and the follow-up year (Y) by the EPOCA RPM system. Statistical analyses were significant at P value <.05.

RESULTS

In total, 80 patients were included in the analysis, with an average age of 87. The results showed a significant reduction (P<.001) between Y-1 and Y in the total number of unplanned hospital admissions (by 57%), hospitalization days (by 49%), and ED visits (by 62%). Our findings reflected a significant decrease per patient from 0.99 to 0.42 in hospital admissions, from 0.99 to 0.37 in ED visits, and a reduction of 9.7 hospitalization days per year (P<.001). Additional analyses stratifying by hospitalization history, disability level, and caregiver status showed that the greatest effect of the RPM system was on patients with high risk and severe disability. Finally, there was no observed increase in mortality or transfers to intensive care units.

CONCLUSIONS

Our findings are consistent with our previous results regarding the potential benefits of the EPOCA RPM system in managing care for polypathological older adult patients, this time with general practitioners as system operators. They also support existing evidence on the promise of RPM in improving care and health outcomes for older adult patients while alleviating hospital burdens by reducing unplanned hospitalizations and ED visits. It is, therefore, essential to incorporate reimbursement policies for these RPM initiatives so as to facilitate their adoption within health care systems and enhance their impact on health outcomes.