title: Telehealth and hospitalizations for Medicare home healthcare patients.
abstract: OBJECTIVE
  To examine the effect of an integrated, clinician-focused telehealth monitoring system on the probability of hospitalization within the first 30-day episode of home healthcare.
  
  
  METHODS
  Retrospective, nonexperimental design.
  
  
  METHODS
  The study sample includes 2009 data from 5873 Medicare beneficiaries receiving home healthcare services through a network of community-based home health agencies operating in Texas and Louisiana. Propensity-score matching was used to control for selection bias. Logistic regression and postestimation parameter simulation were used to assess how the use of an integrated, clinician-focused telehealth monitoring system might affect the probability of hospitalization during the first 30-day episode of home healthcare.
  
  
  RESULTS
  The 30-day probability of hospitalization for telehealth and non-telehealth patients was 10.3% and 17.1%, respectively. Patients in the telehealth group had a 7-percentage-point (95% confidence interval 4.2, 9.4) lower probability of hospitalization within the first 30-day episode of home healthcare than those in the non-telehealth group.
  
  
  CONCLUSIONS
  The use of an integrated, clinician focused telehealth monitoring system can substantially reduce the 30-day probability of hospitalization for home healthcare patients. Telehealth monitoring systems that integrate skilled clinicians can lead to substantial hospitalization-related cost savings.
authors.affiliation: Department of Health Management and Policy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd EAD 709B, Fort Worth, TX 76107, USA. hsueh-fen.chen@unthsc.edu
authors.forename: Hsuch-Fen
authors.initials: HF
authors.lastname: Chen
authors.forename: M Christine
authors.initials: MC
authors.lastname: Kalish
authors.forename: Jose A
authors.initials: JA
authors.lastname: Pagan
mesh_terms: D016001:Confidence Intervals; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D057216:Propensity Score; D017216:Telemedicine / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D013781:Texas; D013997:Time Factors; D014481:United States