Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study
- PDF / 715,629 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 102 Downloads / 140 Views
RESEARCH ARTICLE
Open Access
Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study Rafael Jesus Bautista-Mesa1, Antonio Lopez-Villegas2*, Salvador Peiro3, Daniel Catalan-Matamoros4,5, Emilio Robles-Musso6, Remedios Lopez-Liria7 and Cesar Leal-Costa8
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. Keywords: Cost-utility, Pacemakers follow-up, Quality-adjusted life years, Remote monitoring, Telemedicine
* Correspondence: [email protected] 2 Social Involvement of Critical and Emergency Medicine, CTS–609 Research Group, Hospital de Poniente, El Ejido, s/n, 04700 Almeria, Spain Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in
Data Loading...
