Tele-assistance in patients with amyotrophic lateral sclerosis: long term activity and costs.
OBJECTIVE
To describe i) nurse's utilisation and associated costs during 4-year tele-assistance in amyotrophic lateral sclerosis (ALS) ii) optimal time for initiating tele-assistance.


METHODS
73 ALS patients after hospital discharge were followed up on voice by phone calls conducted by a nurse through a clinical card which was tested for feasibility, efficacy and utility. Number of patients simultaneously assisted/month, calls/patient, fixed and variable costs were calculated.


RESULTS
Time between disease's diagnosis and the beginning of tele-assistance was 720 ± 971 days. ALS patients' percentage managed by nurses through tele-assistance increased over time by 628%. Tele-assistance integrated care (TAIC) followed up patients with a total of 5073 telephone calls. Steady state activity was reached at the 3rd year employing 5 ± 3 calls/pt/month (time/call 64 ± 44 min). Implementing the card was feasible, useful and effective by operator. Survival from diagnosis of ALS was 1224 ± 1150 days. Survival was related to tracheotomy.


CONCLUSIONS
TAIC is a feasible tool to manage up to 25 ALS patients/month/nurse and costs about €105.00 per patient per month. Tele-assistance is proposed at 2/3 of time course of the disease.
Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, IRCCS, Lumezzane (BS), Italy. michele.vitacca@fsm.it
Michele
M
Vitacca
Laura
L
Comini
Giuliano
G
Assoni
Domenico
D
Fiorenza
Sonia
S
Gilè
Palmira
P
Bernocchi
Simonetta
S
Scalvini
D000690:Amyotrophic Lateral Sclerosis / Q000191:economics* / Q000451:nursing / Q000534:rehabilitation; D003266:Continuity of Patient Care / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012129:Respiratory Function Tests; D017216:Telemedicine / Q000379:methods* / Q000458:organization & administration; D013997:Time Factors