[Impact of telemetric management on overall treatment costs and mortality rate among patients with chronic heart failure].
OBJECTIVE
The rising prevalence of chronic heart failure (CHF) has led to an increase in total treatment expenditures. A medical care programme of telemetry was developed to reduce the number of patients with decompensated CHF, hospital admissions and overall treatment cost.


METHODS
As part of a prospective controlled study the body weight of 251 patients with CHF was monitored over one year. The supervising center contacted the patients whenever their body weight exceeded a threshold value. Patients were phoned by a designated personal adviser and received regular informative material and advice by specialist medical personnel. Patients' general practitioners had been involved in recruiting patients and by regularly sending them follow-up reports. Another group of 251 patients who had not received the described telemetric intervention served as control.


RESULTS
The mean age of the patients was 71.7 years, lower than the 76.4 years of the control group. More patients in the intervention groups were in NYHA class III and IV than in the control group (52 % vs 36 %). After an average observation period of 12 months the duration of hospital stay had been reduced by 48 % (p = 0.01), the hospital costs by EUR 7128 per patient p = 0.01), while drug expenditure had increased by EUR 245 per patient (not significant). The total costs had thus fallen by EUR 6993 per patient (-39.5 %; p = 0.05). The mortality rate of 14.7 % in the intervention group was significantly lower than that of the control group of 27.1 % (p = 0.001). The reduction in costs and mortality rate was clearly greater for men than women. Total expenditure had been highest for patients who had died.


CONCLUSIONS
The results indicate that total treatment costs and mortality rate can be reduced by telemetric monitoring of patients in CHF, especially in men.
Kielblock
B
B
Kaufmännische Krankenkasse, Hannover.
Frye
Ch
Ch
Kottmair
S
S
Hudler
Th
T
Siegmund-Schultze
E
E
Middeke
M
M
D000368:Aged; D001835:Body Weight; D002908:Chronic Disease; D017281:Cost of Illness; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000191:economics* / Q000401:mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D012727:Sex Characteristics; D016019:Survival Analysis; D017216:Telemedicine / Q000191:economics*; D016896:Treatment Outcome