Home telecare and nurse telephone calls reduced mean CHF-related readmission charges compared to usual care ($5850 and $7320 vs $44,479), though the difference was not statistically significant.
RCT (n=37)
randomized
Absolute Event Rate: 5850% vs 44479%
p-value: p=not significant
BACKGROUND: The high cost of caring for patients with congestive heart failure (CHF) results primarily from frequent hospital readmissions for exacerbations. Home nurse visits after discharge can reduce readmissions, but the intervention costs are high. OBJECTIVES: To compare the effectiveness of three hospital discharge care models for reducing CHF-related readmission charges: 1) home telecare delivered via a 2-way video-conference device with an integrated electronic stethoscope; 2) nurse telephone calls; and 3) usual outpatient care. RESEARCH DESIGN: One-year randomized trial. SUBJECTS: English-speaking patients 40 years of age and older with a primary hospital admission diagnosis of CHF. MEASURES: Our primary outcome was CHF-related readmission charges during a 6-month period after randomization. Secondary outcomes included all-cause readmissions, emergency department (ED) visits, and associated charges. RESULTS: Thirty-seven subjects were randomized: 13 to home telecare, 12 each telephone care and 12 to usual care. Mean CHF-related readmission charges were 86% lower in the telecare group (5850, SD 21, 094) and 84% lower in the telephone group (7320, SD 24, 440) than in the usual care group (44, 479, SD 121, 214). However, the between-group difference was not statistically significant. Both intervention groups had significantly fewer CHF-related ED visits (P = 0. 0342) and charges (P = 0. 0487) than the usual care group. Trends favoring both interventions were noted for all other utilization outcomes. CONCLUSIONS: Substantial reductions in hospital readmissions, emergency visits, and cost of care for patients with CHF might be achieved by widespread deployment of distance technologies to provide posthospitalization monitoring. Home telecare may not offer incremental benefit beyond telephone follow-up and is more expensive.
Jerant et al. (Thu,) conducted a rct in Congestive Heart Failure (CHF) (n=37). Home telecare or nurse telephone calls vs. Usual outpatient care was evaluated on CHF-related readmission charges during a 6-month period (p=not significant). Home telecare and nurse telephone calls reduced mean CHF-related readmission charges compared to usual care ($5850 and $7320 vs $44,479), though the difference was not statistically significant.