Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Med Care. 2001 Nov;39(11):1234-45.

Reducing the cost of frequent hospital admissions for congestive heart failure: a randomized trial of a home telecare intervention.

Author information

  • 1Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento 95817, USA. afjerant@ucdavis.edu

Abstract

BACKGROUND:

The high cost of caring for patients with congestive heart failure (CHF) results primarily from frequent hospital readmissions for exacerbations. Home nurse visits after discharge can reduce readmissions, but the intervention costs are high.

OBJECTIVES:

To compare the effectiveness of three hospital discharge care models for reducing CHF-related readmission charges: 1) home telecare delivered via a 2-way video-conference device with an integrated electronic stethoscope; 2) nurse telephone calls; and 3) usual outpatient care.

RESEARCH DESIGN:

One-year randomized trial.

SUBJECTS:

English-speaking patients 40 years of age and older with a primary hospital admission diagnosis of CHF.

MEASURES:

Our primary outcome was CHF-related readmission charges during a 6-month period after randomization. Secondary outcomes included all-cause readmissions, emergency department (ED) visits, and associated charges.

RESULTS:

Thirty-seven subjects were randomized: 13 to home telecare, 12 each telephone care and 12 to usual care. Mean CHF-related readmission charges were 86% lower in the telecare group ($5850, SD $21,094) and 84% lower in the telephone group ($7320, SD $24,440) than in the usual care group ($44,479, SD $121,214). However, the between-group difference was not statistically significant. Both intervention groups had significantly fewer CHF-related ED visits (P = 0.0342) and charges (P = 0.0487) than the usual care group. Trends favoring both interventions were noted for all other utilization outcomes.

CONCLUSIONS:

Substantial reductions in hospital readmissions, emergency visits, and cost of care for patients with CHF might be achieved by widespread deployment of distance technologies to provide posthospitalization monitoring. Home telecare may not offer incremental benefit beyond telephone follow-up and is more expensive.

PMID:
11606877
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk