The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men.
This study compared health-related outcomes, during a 1-year period, for two groups of frail elders-one that received care coordination via distance monitoring (home-telehealth) and one that received no intervention. A case-control design was employed. The home telehealth intervention group was made up of 111 male veterans who were enrolled in a Veterans Health Administration project. The control group consisted of 115 men who were referred from either senior service agencies or hospital rehabilitation programs, but did not receive home-telehealth. Subjects in both groups had primary diagnoses of hypertension, diabetes, respiratory disease, or heart disease. The two groups were similar in terms of age, race, marital status, and independence in instrumental activities of daily living (IADL) at baseline. A paired t-test was used to study the before-after (baseline to 12-month follow-up) improvements in the outcome measures within each group. Regression models were used to compare the outcome improvements between the two groups. Over 1 year, the intervention group improved 2.2 points more in IADL, 14.4 points more in FIM motor scores, and 2.7 points more in FIM cognitive scores than the control group (p < 0.0001). This evidence supports the use of a specific home-telehealth strategy for care coordination to improve functional independence in non-institutionalized veterans with chronic disease. A randomized controlled trial should be employed to confirm these findings.
Veterans Affairs Health Services Research & Development/Rehabilitation Research & Development, Rehabilitation Outcomes Research Center (RORC), North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA. Neale.Chumbler@med.va.gov
Neale R
NR
Chumbler
William C
WC
Mann
Samuel
S
Wu
Arlene
A
Schmid
Rita
R
Kobb
D000203:Activities of Daily Living; D000368:Aged; D016022:Case-Control Studies; D003071:Cognition; D005431:Florida; D016330:Frail Elderly; D005845:Georgia; D006302:Health Services Research; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D017216:Telemedicine; D014728:Veterans