Jun 23, 2012

Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial

BMJ : British Medical Journal
A SteventonWhole System Demonstrator evaluation team

Abstract

To assess the effect of home based telehealth interventions on the use of secondary healthcare and mortality. Pragmatic, multisite, cluster randomised trial comparing telehealth with usual care, using data from routine administrative datasets. General practice was the unit of randomisation. We allocated practices using a minimisation algorithm, and did analyses by intention to treat. 179 general practices in three areas in England. 3230 people with diabetes, chronic obstructive pulmonary disease, or heart failure recruited from practices between May 2008 and November 2009. Telehealth involved remote exchange of data between patients and healthcare professionals as part of patients' diagnosis and management. Usual care reflected the range of services available in the trial sites, excluding telehealth. Proportion of patients admitted to hospital during 12 month trial period. Patient characteristics were similar at baseline. Compared with controls, the intervention group had a lower admission proportion within 12 month follow-up (odds ratio 0.82, 95% confidence interval 0.70 to 0.97, P = 0.017). Mortality at 12 months was also lower for intervention patients than for controls (4.6% v 8.3%; odds ratio 0.54, 0.39 to 0.75, P < 0.001)...Continue Reading

  • References29
  • Citations181

References

  • References29
  • Citations181

Citations

Mentioned in this Paper

Hospitalization
Logistic Regression
Family Medicine (Field)
General Practice (Field)
Decline, Mortality
Hospital Stay
Chronic Obstructive Airway Disease
Accident and Emergency Department
Congestive Heart Failure
Heart Failure

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