Abstract
Aims: To study healthcare utilization/costs by compliance for Lung CA patients home-telemonitoring (TM) after feasibility (Petitte et al., ONF, 41(2), 153–161).
Methods: RCT 47 rural-patients (TM N=26; C N=21) with NSCLungCA: married, had smoked, HS educated, overweight BMI. RN-coached patients 14 days using TM-data. Healthcare use and cost (one-year direct medical cost) compared to baseline.
Results: 2-month study TM patients survived longer; had more unplanned calls to doctors/nurses (32% vs. 30% & 64% vs. 50%); fewer rehospitalizations (28% vs. 40%) and higher ER use (36% vs. 30%). TM compliant group had least ER visits/rehospitalizations (RH) of 3 subgroups (see figure: ER visit: 29% [30-50%; RH: 18% [40-50%)
TM group had higher in-hospital costs prior to enrollment & during study; 4 months following-average TM costs lower (USD: $31,188 vs. $40,593). Lower costs (control) may relate to earlier deaths. TM group had relative improvements on health utility value (0.08; 0=death/1=perfect health)
Conclusions: Home TM in rural areas can decrease acute-care use for patients with lungCA but no significant impact on cost. Overall TM cost may be higher; improved life-quality may justify cost if TM limitations can be addressed. Findings limited by attrition/cost effects. Next: study with a larger sample to validate trends for positive patient & cost outcomes in rural areas.
(Funded NIH R15CA150999)
- © 2014 ERS