Key result
Home blood-pressure monitoring linked to ~£201 lower weekly healthcare costs per patient.
Why the study?
Does home blood-pressure monitoring (with or without a smartphone app) reduce healthcare costs and outpatient hospital visits without compromising safety compared to traditional hospital monitoring in hypertensive pregnant women?
Case-Control (n=166)
No
Does home blood-pressure monitoring (with or without a smartphone app) reduce healthcare costs and outpatient hospital visits without compromising safety compared to traditional hospital monitoring in hypertensive pregnant women?
Home blood-pressure monitoring in hypertensive pregnant women reduces outpatient day assessment unit visits and saves an average of £200.69 to £286.53 per patient per week without increasing maternal, fetal, or neonatal adverse outcomes.
Answers are grounded in this paper and cite their sources.
May support cost savings in hypertensive pregnancies; leaves open confirmation of safety and efficacy in randomized trials.
OBJECTIVE: Traditional blood-pressure monitoring in hypertensive pregnant women requires frequent visits to the maternity outpatient services. Home blood-pressure monitoring (HBPM) could offer a cost-saving alternative that is acceptable to patients. The aim of this study was to undertake a health economic analysis of HBPM compared with traditional monitoring in hypertensive pregnant women. METHODS: This was a cost-minimization study of hypertensive pregnant women who had HBPM with or without the adjunct of a smartphone application (App), via a specially designed pathway, and a control group managed according to the local protocol of regular hospital visits for blood-pressure monitoring. Outcome measures were the number of outpatient visits, inpatient bed stays and investigations performed. Maternal, fetal and neonatal adverse outcomes were also recorded. Health economic analysis was performed using direct cost comparison of the study dataset and process scenario modeling. RESULTS: The HBPM group included 108 women, of whom 29 recorded their results on the smartphone App and 79 in their notes. The control group comprised 58 patients. There were significantly more women with chronic hypertension in the HBPM group than in the control group (49.1% vs 25.9%, P = 0.004). The HBPM group had significantly longer duration of monitoring (9 weeks vs 5 weeks, P = 0.004) and started monitoring at an earlier gestational age (30.0 weeks vs 33.6 weeks, P = 0.001) compared with the control group. Despite these differences, the mean saving per week for each patient using HBPM compared with traditional monitoring was £200.69, while for each HBPM patient using the smartphone App, the weekly saving was £286.53 compared with the control group. The process modeling method predicted weekly savings of between £98.32 and £245.80 per patient using HBPM compared with traditional monitoring. CONCLUSION: HBPM in hypertensive pregnancy appears to be cost saving compared with traditional monitoring, without compromising maternal, fetal or neonatal safety. Larger studies are required to confirm these findings.
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Xydopoulos et al. (2018) conducted a case-control in Hypertensive disorders of pregnancy (chronic hypertension, gestational hypertension, pre-eclampsia) (n=166). Home blood-pressure monitoring (HBPM) with or without a smartphone application vs. Traditional hospital outpatient monitoring at a day assessment unit (DAU) was evaluated on Direct healthcare cost of blood-pressure monitoring per patient per week and Day Assessment Unit (DAU) visits (Mean weekly cost saving of £200.69 (overall HBPM) and £286.53 (App-HBPM), p=<0.001). Home blood-pressure monitoring reduced weekly healthcare costs by £200.69 per patient (£286.53 with a smartphone app) and significantly decreased day assessment unit visits (P<0.001).
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