title: An observational study of veterans with diabetes receiving weekly or daily home telehealth monitoring.
abstract: We assessed the utilization of health-care services and clinical outcomes in veterans with diabetes who were enrolled in two care coordination/home telehealth programmes. One group of patients was monitored weekly (n = 197), with more intensive evaluations, while the other was monitored daily (n = 100), but less intensively. Although patients in the two groups were fairly similar in demographic terms and in their clinical characteristics at baseline, they had different service utilization patterns during the 12-month pre-enrollment period. Over the 12-month study period, the proportion of one or more hospital admissions and number of bed days of care decreased in the daily monitoring group, and increased in the weekly monitoring group, more or less doubling in the former and being halved in the latter. Unscheduled primary care clinic visits were lower in the daily monitored group than in the weekly monitored group. The differences between the two groups were significant (P < 0.01). There were no significant differences between the groups in the clinical outcomes. Future research should employ randomized controlled trial designs to determine if intensities of home monitoring lead to differences in service utilization and health outcomes.
authors.affiliation: VA HSR&D/RR&D Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida 32608, USA. Neale.Chumbler@med.va.gov
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
authors.forename: Britta
authors.initials: B
authors.lastname: Neugaard
authors.forename: Patricia
authors.initials: P
authors.lastname: Ryan
authors.forename: Haijing
authors.initials: H
authors.lastname: Qin
authors.forename: Yongsung
authors.initials: Y
authors.lastname: Joo
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D005431:Florida; D005845:Georgia; D006699:Home Care Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D017216:Telemedicine; D014728:Veterans