Program Evaluation of Remote Heart Failure Monitoring: Healthcare Utilization Analysis in a Rural Regional Medical Center
Program Evaluation of Remote Heart Failure Monitoring: Healthcare Utilization Analysis in a Rural Regional Medical Center
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DOI：
10.1089/tmj.2014.0093
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发表时间：
2015-03-01
影响因子：
4.7
通讯作者：
Carroll, Mark
中科院分区：
文献类型：
--
作者：
Riley, William T.;Keberlein, Pamela;Carroll, Mark
背景资料：心力衰竭（HF）的远程监测在研究中具有混合和异质性效应，需要在特定医疗保健系统及其患者人群中进一步评价远程监测系统。“墙和线之外的护理”是一项无线远程监测计划，旨在促进患者和护理团队对HF患者的共同管理，由农村地区医疗中心提供服务，为评估该计划对医疗保健利用的影响提供了机会。材料和方法：50例在弗拉格斯塔夫医学中心（弗拉格斯塔夫，AZ）住院的HF患者参加了该项目。这些患者中的许多人生活在服务不足的农村社区，包括美洲原住民保留地。入组的患者接受移动的、支持宽带的远程监测设备。确定匹配的队列进行比较。结果如下：入组该计划的HF患者在入组后6个月内显示出医疗保健利用的显著性和统计学显著性降低，与拒绝参与的患者相比，这些降低显著更大，但与匹配队列相比则没有。结论：该项目的研究结果表明，远程HF监测计划可以成功地在农村，服务不足的地区实施。在计划参与者中观察到医疗保健利用率降低，但在匹配的队列中也观察到降低，说明需要严格评估HF远程监测计划在医疗保健系统中的影响。
Background: Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Materials and Methods: Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. Results: HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. Conclusions: The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.