Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study
Abstract Background Cost-effectiveness studies on pacemakers have increased in the last years. However the number of long-term cost-utility studies is limited. The objective of this study was to perform a cost-utility analysis comparing remote monitoring (RM) versus conventional monitoring (CM) in h...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-020-01883-3 |
| _version_ | 1818408126165024768 |
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| author | Rafael Jesus Bautista-Mesa Antonio Lopez-Villegas Salvador Peiro Daniel Catalan-Matamoros Emilio Robles-Musso Remedios Lopez-Liria Cesar Leal-Costa |
| author_facet | Rafael Jesus Bautista-Mesa Antonio Lopez-Villegas Salvador Peiro Daniel Catalan-Matamoros Emilio Robles-Musso Remedios Lopez-Liria Cesar Leal-Costa |
| author_sort | Rafael Jesus Bautista-Mesa |
| collection | DOAJ |
| description | Abstract Background Cost-effectiveness studies on pacemakers have increased in the last years. However the number of long-term cost-utility studies is limited. The objective of this study was to perform a cost-utility analysis comparing remote monitoring (RM) versus conventional monitoring (CM) in hospital of older patients with pacemakers, 5 years after implant. Methods Under a controlled, not randomized, nor masked clinical trial, 83 patients with pacemakers were initially selected. After five years of follow-up, a total of 55 patients (CM = 34; RM = 21) completed the study. A cost-utility analysis of RM in terms of costs per gained quality-adjusted life years (QALYs) was conducted. The costs from the Public Health System (PHS) as well as patients and their relatives were taken into account for the study. The robustness of the results was verified by the probabilistic analyses through Monte-Carlo simulations. Results After a five-year follow-up period, total costs were lower in the RM group by 23.02% than in the CM group (€274.52 versus €356.62; p = 0.033) because of a cost saving from patients’ perspective (€59.05 versus €102.98; p = 0.002). However, the reduction of in-hospital visits derived from RM exhibited insignificant impact on the costs from the PHS perspective, with a cost saving of 15.04% (€215.48 vs. €253.64; p = 0.144). Costs/QALYs obtained by the RM group were higher as compared to the CM group, although there were no significant differences. The incremental cost-effectiveness ratio of CM in comparison to RM became positive (€301.16). Conclusions This study confirms RM of older patients with pacemakers appears still as a cost-utility alternative to CM in hospital after 5 years of follow-up. Trial registration ClinicalTrials.gov: (Identifier: NCT02234245 ). Registered 09 September 2014 - Prospectively registered. |
| first_indexed | 2024-12-14T09:38:46Z |
| format | Article |
| id | doaj.art-3b333d1e3808414296f41a13498e43f8 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-14T09:38:46Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-3b333d1e3808414296f41a13498e43f82022-12-21T23:07:52ZengBMCBMC Geriatrics1471-23182020-11-0120111210.1186/s12877-020-01883-3Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE studyRafael Jesus Bautista-Mesa0Antonio Lopez-Villegas1Salvador Peiro2Daniel Catalan-Matamoros3Emilio Robles-Musso4Remedios Lopez-Liria5Cesar Leal-Costa6Management Unit, Hospital de PonienteSocial Involvement of Critical and Emergency Medicine, CTS–609 Research Group, Hospital de PonienteHealth Services Research Unit, FISABIO-PUBLIC HEALTHDepartment of Communication Studies, University Carlos III of MadridPacemaker Unit, Intensive Care Unit, Hospital de PonienteDepartment of Nursing Science, Physiotherapy and Medicine, Hum–498 Research Team, Health Research Centre, University of AlmeríaNursing Department, University of MurciaAbstract Background Cost-effectiveness studies on pacemakers have increased in the last years. However the number of long-term cost-utility studies is limited. The objective of this study was to perform a cost-utility analysis comparing remote monitoring (RM) versus conventional monitoring (CM) in hospital of older patients with pacemakers, 5 years after implant. Methods Under a controlled, not randomized, nor masked clinical trial, 83 patients with pacemakers were initially selected. After five years of follow-up, a total of 55 patients (CM = 34; RM = 21) completed the study. A cost-utility analysis of RM in terms of costs per gained quality-adjusted life years (QALYs) was conducted. The costs from the Public Health System (PHS) as well as patients and their relatives were taken into account for the study. The robustness of the results was verified by the probabilistic analyses through Monte-Carlo simulations. Results After a five-year follow-up period, total costs were lower in the RM group by 23.02% than in the CM group (€274.52 versus €356.62; p = 0.033) because of a cost saving from patients’ perspective (€59.05 versus €102.98; p = 0.002). However, the reduction of in-hospital visits derived from RM exhibited insignificant impact on the costs from the PHS perspective, with a cost saving of 15.04% (€215.48 vs. €253.64; p = 0.144). Costs/QALYs obtained by the RM group were higher as compared to the CM group, although there were no significant differences. The incremental cost-effectiveness ratio of CM in comparison to RM became positive (€301.16). Conclusions This study confirms RM of older patients with pacemakers appears still as a cost-utility alternative to CM in hospital after 5 years of follow-up. Trial registration ClinicalTrials.gov: (Identifier: NCT02234245 ). Registered 09 September 2014 - Prospectively registered.http://link.springer.com/article/10.1186/s12877-020-01883-3Cost-utilityPacemakers follow-upQuality-adjusted life yearsRemote monitoringTelemedicine |
| spellingShingle | Rafael Jesus Bautista-Mesa Antonio Lopez-Villegas Salvador Peiro Daniel Catalan-Matamoros Emilio Robles-Musso Remedios Lopez-Liria Cesar Leal-Costa Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study BMC Geriatrics Cost-utility Pacemakers follow-up Quality-adjusted life years Remote monitoring Telemedicine |
| title | Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study |
| title_full | Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study |
| title_fullStr | Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study |
| title_full_unstemmed | Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study |
| title_short | Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study |
| title_sort | long term cost utility analysis of remote monitoring of older patients with pacemakers the poniente study |
| topic | Cost-utility Pacemakers follow-up Quality-adjusted life years Remote monitoring Telemedicine |
| url | http://link.springer.com/article/10.1186/s12877-020-01883-3 |
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