TY - JOUR
T1 - Economic analysis of remote monitoring of cardiac implantable electronic devices
T2 - Results of the Health Economics Evaluation Registry for Remote Follow-up (TARIFF) study
AU - Ricci, Renato Pietro
AU - Vicentini, Alfredo
AU - D'Onofrio, Antonio
AU - Sagone, Antonio
AU - Rovaris, Giovanni
AU - Padeletti, Luigi
AU - Morichelli, Loredana
AU - Fusco, Antonio
AU - De Vivo, Stefano
AU - Lombardi, Leonida
AU - Denaro, Alessandra
AU - Pollastrelli, Annalisa
AU - Colangelo, Irene
AU - Santini, Massimo
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background Remote monitoring (RM) of cardiac implantable electronic devices has been demonstrated to improve outpatient clinic workflow and patient management. However, few data are available on the socioeconomic impact of RM. Objective The aim of this study was to assess the costs and benefits of RM compared with standard care (SC). Methods We used 12-month patient data from the Health Economics Evaluation Registry for Remote Follow-up (TARIFF) study (N = 209; RM: n = 102 (48.81%); SC: n = 107 (51.19%)). Cost comparison was made from 2 perspectives: the health care system (HCS) and patients. The use of health care resources was defined on the basis of hospital clinical folders. Out-of-pocket expenses were reported directly by patients. Results HCS perspective: The overall mean annual cost per patient in the SC group (€1044.89 ± €1990.47) was significantly higher than in the RM group (€482.87 ± €2488.10) (P <.0001), with a reduction of 53.87% being achieved in the RM group. The primary driver of cost reduction was the cost of cardiovascular hospitalizations (SC: €886.67 ± €1979.13 vs RM: €432.34 ± €2488.10; P =.0030). Patient and caregiver perspective: The annual cost incurred by patients was significantly higher in the SC group than in the RM group (SC: €169.49 ± €189.50 vs RM: €56.87 ± €80.22; P <.0001). Patients’ quality-adjusted life-years were not significantly different between the groups. Provider perspective: The total number of inhospital device follow-up visits was reduced by 58.78% in the RM group. Conclusion RM of patients with cardiac implantable electronic devices (CIEDs) is cost saving from the perspectives of the HCS, patients, and caregivers. Introducing appropriate reimbursements will make RM sustainable even for the provider, i.e. the hospitals which provide the service and encourage widespread adoption of RM.
AB - Background Remote monitoring (RM) of cardiac implantable electronic devices has been demonstrated to improve outpatient clinic workflow and patient management. However, few data are available on the socioeconomic impact of RM. Objective The aim of this study was to assess the costs and benefits of RM compared with standard care (SC). Methods We used 12-month patient data from the Health Economics Evaluation Registry for Remote Follow-up (TARIFF) study (N = 209; RM: n = 102 (48.81%); SC: n = 107 (51.19%)). Cost comparison was made from 2 perspectives: the health care system (HCS) and patients. The use of health care resources was defined on the basis of hospital clinical folders. Out-of-pocket expenses were reported directly by patients. Results HCS perspective: The overall mean annual cost per patient in the SC group (€1044.89 ± €1990.47) was significantly higher than in the RM group (€482.87 ± €2488.10) (P <.0001), with a reduction of 53.87% being achieved in the RM group. The primary driver of cost reduction was the cost of cardiovascular hospitalizations (SC: €886.67 ± €1979.13 vs RM: €432.34 ± €2488.10; P =.0030). Patient and caregiver perspective: The annual cost incurred by patients was significantly higher in the SC group than in the RM group (SC: €169.49 ± €189.50 vs RM: €56.87 ± €80.22; P <.0001). Patients’ quality-adjusted life-years were not significantly different between the groups. Provider perspective: The total number of inhospital device follow-up visits was reduced by 58.78% in the RM group. Conclusion RM of patients with cardiac implantable electronic devices (CIEDs) is cost saving from the perspectives of the HCS, patients, and caregivers. Introducing appropriate reimbursements will make RM sustainable even for the provider, i.e. the hospitals which provide the service and encourage widespread adoption of RM.
KW - Cost-effectiveness
KW - Implantable cardioverter-defibrillator
KW - Reimbursement
KW - Remote monitoring
KW - Telemedicine
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U2 - 10.1016/j.hrthm.2016.09.008
DO - 10.1016/j.hrthm.2016.09.008
M3 - Article
AN - SCOPUS:85006459224
VL - 14
SP - 50
EP - 57
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 1
ER -