Tele-assistance in chronic respiratory failure: Patients' characterization and staff workload of 5-year activity

Michele Vitacca, Abramo Bazza, Luca Bianchi, Sonia Gilè, Giuliano Assoni, Roberto Porta, Enrica Bertella, Domenico Fiorenza, Luca Barbano, Laura Comini, Simonetta Scalvini

Research output: Contribution to journalArticle

Abstract

Background: The issue of how to optimize the routine use of tele-assistance (TA) in the clinical care remains to be addressed. Skills and costs of human resources represent the major component to care for chronic patients with TA. Methods: We investigated (1) the change in patient population, mortality, and staff utilization/cost during the first 5-year activity of a TA program (24-h availability of a call center, pulse oxygen device, and second medical opinion) dedicated to chronic respiratory failure patients and (2) the staff time dedicated to each new patient admitted to the service. Results: Three-hundred and ninty-six patients (age 64±17 years; 296 men) were reviewed across 5 years of activity. Patients followed/year increased over time, particularly for amyotrophic lateral sclerosis subjects. Calls/month dramatically increased from 60 to 290, with a 5-year number of calls equal to 12.952. The doctor's time dedicated to TA decreased over time, whereas the nurse's time increased allowing a cost saving of 39% when compared with budgeted salary costs. The number of home ventilated patients did not change, remaining over 78%. The mortality rate increased over time (from 6% to 11%). Both chronic obstructive pulmonary disease (COPD) and No-COPD patients used the TA service more frequently during the winter, and COPD used it also in the summer. Conclusions: A stable TA service dedicated to chronic respiratory failure may be reached after 4 years. Across years, (1) number of patients increased, with COPD and ventilated subjects being the most representative; (2) calls varied during seasons; (3) doctor's workload decreased, saving salary costs; and (4) each new enrolled patient may require 73 and 27min/month of nurse and doctor, respectively.

Original languageEnglish
Pages (from-to)299-305
Number of pages7
JournalTelemedicine journal and e-health : the official journal of the American Telemedicine Association
Volume16
Issue number3
DOIs
Publication statusPublished - Apr 1 2010

Keywords

  • Chronic respiratory diseases
  • COPD
  • Nurse
  • Tele-assistance
  • Telemedicine

ASJC Scopus subject areas

  • Medicine(all)
  • Health Informatics
  • Health Information Management

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