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Telemedical Care and Monitoring for Patients with Chronic Heart Failure Has a Positive Effect on Survival
Author(s) -
Herold Robert,
Berg Neeltje,
Dörr Marcus,
Hoffmann Wolfgang
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12661
Subject(s) - medicine , heart failure , propensity score matching , reimbursement , clinical endpoint , randomized controlled trial , physical therapy , health care , emergency medicine , economics , economic growth
Background Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. Methods We evaluated a large‐sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year. Results Analyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR : 1.47, CI 95 percent: 1.21–1.80, p < .001) and 2 years (adjusted OR : 1.51, CI 95 percent: 1.28–1.77, p < .001), respectively. Conclusions The probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care.