Effect of a home monitoring system on hospitalization and resource use for patients with heart failure.
BACKGROUND
Heart failure has a large medical and economic impact on the elderly. Past studies have shown that high-intensity multidisciplinary interventions at academic medical centers can reduce future hospitalizations. Our pilot study examined the effects of a low-intensity monitoring program on hospitalizations and cost of care for patients with heart failure treated by community physicians.


METHODS
We enrolled 68 patients with heart failure (mean age 73 +/- 13 years, 53% male) monitored by 31 physicians in a multidisciplinary program of patient education, daily self-monitoring, and physician notification of abnormal weight gain, vital signs, and symptoms. Comparisons of medical claims were made between the patients who received the intervention and a control group of 86 patients matched to the intervention group on medical claims during the preceding year.


RESULTS
Compared with the prior year, medical claims per year decreased in the intervention group ($8500 +/- $13,000 to $7400 +/- $11,400), whereas they increased in the control group ($9200 +/- $15,000 to $18,800 +/- $34,000, P <.05). Similar differences were observed for hospitalizations and total hospital days. The program's effectiveness was unrelated to age, sex, or type of left ventricular dysfunction.


CONCLUSIONS
These findings suggest that a multidisciplinary program of patient education, monitoring, and physician notification can reduce resource use in patients with heart failure managed in a community setting.
Heidenreich
P A
PA
Cardiology Section, Department of the Veterans Affairs Medical Center, Palo Alto, CA, 94304, USA.
Ruggerio
C M
CM
Massie
B M
BM
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006333:Heart Failure / Q000191:economics / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods*; D010353:Patient Education as Topic; D011788:Quality of Life; D015996:Survival Rate; D013689:Telephone