Telehealth Intervention Linked to Lower Admission Rates
Remote exchange of data between patients, health care professionals also linked to lower mortality
FRIDAY, June 22 (HealthDay News) -- A telehealth intervention is associated with improved emergency admission rates and lower mortality compared with usual care, according to a study published online June 21 in BMJ.
Adam Steventon, from The Nuffield Trust in London, and colleagues used information from routine administrative datasets to conduct a multisite, cluster randomized trial comparing telehealth with usual care. A total of 3,230 individuals with diabetes, chronic obstructive pulmonary disease, or heart failure, recruited from 179 general practices in three areas of England, were allocated to receive telehealth, which included remote exchange of data between patients and health care professionals, or usual care.
The researchers found that the intervention group had a lower proportion of admissions during 12 months of follow-up compared with controls (odds ratio, 0.82; P = 0.017). At 12 months, mortality was lower for intervention participants than controls (4.6 versus 8.3 percent; odds ratio, 0.54). These differences persisted after adjustment. The mean number of emergency admissions was lower in the intervention group in unadjusted analyses, with the difference significant after adjustment for a predictive risk score but not after adjustment for baseline characteristics. The greatest difference in emergency admissions was seen at the start of the trial, when the control group experienced a large increase. Intervention patients experienced a significantly shorter length of stay. Differences in other forms of hospital use, including costs, were generally not significant.
"Our results suggest that telehealth helped patients to avoid the need for emergency hospital care," the authors write. "Further analyses will provide insights into the mechanisms by which telehealth can lead to reductions in admission rates."
Full Text (http://www.bmj.com/content/344/bmj.e3874 )Editorial (subscription or payment may be required) (http://www.bmj.com/content/344/bmj.e4201 )