SAFE@HOME: Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia

OBJECTIVE: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia. STUDY DESIGN: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring. MAIN OUTCOME MEASURES: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence. RESULTS: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 - 5329] vs €4504 [IQR 3515-6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338-10,173] vs €9150, [IQR 7546-12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources. CONCLUSION: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.