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

Medical Care
A F JerantT S Nesbitt

Abstract

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. 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. One-year randomized trial. English-speaking patients 40 years of age and older with a primary hospital admission diagnosis of CHF. 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. 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...Continue Reading

References

Nov 1, 1975·Journal of Psychiatric Research·M F FolsteinP R McHugh
Apr 1, 1991·American Journal of Diseases of Children·E W NelsonP L McCarthy
Dec 1, 1990·Journal of the American Geriatrics Society·J M VinsonT McNamara
Apr 1, 1997·American Journal of Public Health·M H Chin, L Goldman
May 1, 1997·Journal of the American Geriatrics Society·F D WolinskyR M Lubitz
Jul 1, 1997·The Journal of Cardiovascular Nursing·M B HappP Roe-Prior
Jun 15, 1997·The American Journal of Cardiology·M H Chin, L Goldman
Jul 9, 1997·JAMA : the Journal of the American Medical Association·E A BalasJ A Mitchell
Aug 1, 1997·Journal of the American Geriatrics Society·M W Rich
Dec 31, 1997·The American Journal of Cardiology·D B Mark
Jan 1, 1995·Journal of Telemedicine and Telecare·K Mahmud, J Lenz
Mar 4, 1998·The Medical Journal of Australia·J M LoweP J Fletcher
Apr 29, 1998·JAMA : the Journal of the American Medical Association·S K InouyeJ Concato
Apr 9, 1999·Journal of Cardiac Failure·M W Rich
Feb 9, 2000·Archives of Family Medicine·B JohnstonK H Sousa
Mar 10, 2001·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·H AgrellA F Jerant

❮ Previous
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Citations

Sep 24, 2005·Herzschrittmachertherapie & Elektrophysiologie·C ZugckA Remppis
Jun 5, 2007·Current Cardiology Reports·Abul KashemAlfred A Bove
Jun 5, 2007·Current Cardiology Reports·Monica Colvin Adams, Syed Sohail Ali
Jun 12, 2003·The American Journal of Medicine·Gordon D SchiffRobert A McNutt
Jul 22, 2009·International Journal of Technology Assessment in Health Care·Julie PolisenaSarah McGill
Mar 22, 2013·International Journal of Technology Assessment in Health Care·Guy ParéClaude Sicotte
Oct 15, 2013·Social Work in Health Care·Nicole Ruggiano, David Edvardsson
Aug 14, 2013·Home Health Care Services Quarterly·Nicole RuggianoTimothy F Page
Aug 21, 2004·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Helen C NoelForrest Levin
Aug 21, 2004·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Usha SubramanianDavid Smith
Apr 29, 2005·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Lorraine Pellegrino, Rita Kobb
Jul 23, 2005·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Paul J HeinzelmannJoseph C Kvedar
Feb 16, 2006·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Stuti DangBernard A Roos
Jun 27, 2006·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Faith HoppJulie Lowery
Sep 1, 2006·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Abul KashemAlfred A Bove
Sep 27, 2008·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Emily Seto
Oct 29, 2008·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Bonnie J WakefieldGary E Rosenthal
Nov 28, 2008·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Stephanie Vergara Rojas, Marie-Pierre Gagnon
Nov 28, 2008·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Terry RabinowitzPeter Yellowlees
Oct 17, 2009·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Stuti DangGeetanjali Kelkar
Jan 13, 2010·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Lavoisier Cardozo, Joel Steinberg
Nov 26, 2009·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Kathryn Dansky, Joseph Vasey
Dec 4, 2009·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·María E DávalosScott C Simmons
Jan 15, 2010·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Terry RabinowitzPaul A Newhouse
Dec 29, 2010·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Shu-Hsia LinWen-Ta Chiu
Dec 28, 2012·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Jenice Ria S Guzman-ClarkTheodore J Hahn
Oct 15, 2003·Home Healthcare Nurse·Rhonda Chetney
Oct 3, 2006·Home Healthcare Nurse·Christina Quinn
Jan 17, 2007·The Journal of Cardiovascular Nursing·Kathryn H Bowles, Amy C Baugh
Mar 24, 2006·Computers, Informatics, Nursing : CIN·Gail E Bond
Feb 22, 2012·The Journal of Cardiovascular Nursing·Bonnie J WakefieldVicki S Conn
Aug 28, 2012·The Journal of Nursing Administration·Linda S AustinKenneth H Hanger
Nov 5, 2002·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Kenneth W Kizer
May 28, 2004·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Laura E Peterson
Aug 11, 2010·BMC Health Services Research·Victoria A WadeJanet E Hiller
Oct 27, 2009·Cost Effectiveness and Resource Allocation : C/E·Trine S Bergmo
Feb 26, 2003·PharmacoEconomics·Simon Stewart, John D Horowitz
Feb 6, 2014·International Journal of Technology Assessment in Health Care·Andrija S GrustamHubertus J M Vrijhoef
Jan 28, 2014·Current Cardiology Reports·Eric M RilesA Mark Fendrick

❮ Previous
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