Key result
A novel hybrid modeling approach demonstrated that average expenses for treating NYHA class IV heart failure patients (€10,077 ± €165) more than doubled compared to other classes, and a telemonitoring program showed potential cost savings within two years.
Why the study?
Demographic changes and rising chronic diseases challenge public health systems, necessitating modeling tools to evaluate the impact of integrated care concepts on heart failure outcomes and health care budgets.
Does a telemonitoring program reduce treatment costs and improve outcomes in heart failure patients compared to conventional care in a simulated model?
Does a telemonitoring program reduce treatment costs and improve outcomes in heart failure patients compared to conventional care in a simulated model?
A novel hybrid simulation model based on real-world Austrian data demonstrates that heart failure costs are heavily driven by NYHA class IV patients and that telemonitoring may offer cost savings.
Telemonitoring may reduce modeled costs in NYHA IV HF; leaves open prospective validation before practice change.
BACKGROUND: Demographic changes, increased life expectancy and the associated rise in chronic diseases pose challenges to public health care systems. Optimized treatment methods and integrated concepts of care are potential solutions to overcome increasing financial burdens and improve quality of care. In this context modeling is a powerful tool to evaluate potential benefits of different treatment procedures on health outcomes as well as health care budgets. This work presents a novel modeling approach for simulating different treatment procedures of heart failure patients based on extensive data sets from outpatient and inpatient care. METHODS: Our hybrid heart failure model is based on discrete event and agent based methodologies and facilitates the incorporation of different therapeutic procedures for outpatient and inpatient care on patient individual level. The state of health is modeled with the functional classification of the New York Heart Association (NYHA), strongly affecting discrete state transition probabilities alongside age and gender. Cooperation with Austrian health care and health insurance providers allowed the realization of a detailed model structure based on clinical data of more than 25,000 patients. RESULTS: Simulation results of conventional care and a telemonitoring program underline the unfavorable prognosis for heart failure and reveal the correlation of NYHA classes with health and economic outcomes. Average expenses for the treatment of NYHA class IV patients of €10,077 ± €165 were more than doubled compared to other classes. The selected use case of a telemonitoring program demonstrated potential cost savings within two years of application. NYHA classes II and III revealed most potential for additional treatment measures. CONCLUSION: The presented model allows performing extensive simulations of established treatment procedures for heart failure patients and evaluating new holistic methods of care and innovative study designs. This approach offers health care providers a unique, adaptable and comprehensive tool for decision making in the complex and socioeconomically challenging field of cardiovascular diseases.
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Lassnig et al. (2019) studied Heart failure (n=25,000). Telemonitoring program vs. Conventional care was evaluated. A novel hybrid modeling approach demonstrated that average expenses for treating NYHA class IV heart failure patients (€10,077 ± €165) more than doubled compared to other classes, and a telemonitoring program showed potential cost savings within two years.
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