title: Long-term effect of home telehealth services on preventable hospitalization use.
abstract: In this study, we assessed the longitudinal effect of a Department of Veterans Affairs (VA) patient-centered Care Coordination Home Telehealth (CCHT) program on preventable hospitalization use by veterans with diabetes mellitus (DM) at four VA medical centers. We used a matched treatment-control design (n = 387 for both groups). All patients were followed for 4 years. We operationalized ambulatory care-sensitive conditions (ACSCs) by applying Agency for Healthcare Research and Quality criteria to VA inpatient databases to determine preventable hospitalization use. We used a generalized linear mixed model to estimate the adjusted effect of the CCHT program on preventable hospitalization use over time. During the initial 18 months of follow-up, CCHT enrollees were less likely to be admitted for a preventable hospitalization than their nonenrollee counterparts, and this difference diminished during the rest of the 4-year follow-up period. The VA CCHT program for DM patients reduced preventable hospitalizations. These findings are some of the first that have systematically examined the extent to which home telehealth programs have a long-term effect on preventable hospitalization use.
authors.affiliation: VA Rehabilitation Outcomes Research Center (151B), 1601 SW Archer Road, Gainesville, FL 32608, USA. Huanguang.Jia@va.gov
authors.forename: Huanguang
authors.initials: H
authors.lastname: Jia
authors.forename: Ho-Chih
authors.initials: HC
authors.lastname: Chuang
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Wu
authors.forename: Xinping
authors.initials: X
authors.lastname: Wang
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D048909:Diabetes Complications / Q000517:prevention & control*; D005260:Female; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods*; D012189:Retrospective Studies; D017216:Telemedicine / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs