title: Costs and benefits of personalized healthcare for patients with chronic heart failure in the care and education program "Telemedicine for the Heart".
abstract: OBJECTIVE
  A health economic analysis was conducted to evaluate the program "Telemedicine for the Heart," which the German Foundation for the Chronically Ill organizes for the Techniker Krankenkasse, one of the biggest German statutory health insurance funds. The program consists of nurse-calls to motivate patients to perform regular self-measurements (blood pressure, pulse, weight) with either their own or telemedical measuring devices provided by the program. In the case of measured values outside of set limits, calls to treating physicians were placed to allow for the initiation of therapy adjustments where applicable.
  
  
  METHODS
  To evaluate the program, a retrospective matched-pairs analysis was performed. Program participants (n=281) and regularly insured patients (n=843) were matched for demographics and morbidity status and compared according to their use of resources.
  
  
  RESULTS
  Significant cost differences in favor of the study group of up to 25% in relation to total costs could be detected, particularly in the group of New York Heart Association (NYHA) classification II patients (persons with mild symptoms and slight limitation according to the NYHA classification for the extent of heart failure). In the more severe NYHA stages III and IV the cost relation differed and showed a slight cost disadvantage for the program group. Mortality was 35.1% lower in the program group than in the control group. Quality of life measures were almost constant over the observation time, compatible with a positive impact of the program on the highly impaired patient group.
  
  
  CONCLUSIONS
  The findings suggest that, besides a reduction of costs, by participating in "Telemedicine for the Heart" patients with chronic heart failure experienced a reduced number of hospital stays, optimized medical therapy, better quality of life, and reduced mortality.
authors.affiliation: Healthcare Management, University Erlangen-Nuremberg, Nuremberg, Germany. stefan.sohn@wiso.uni-erlangen.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Sohn
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Helms
authors.forename: Jörg T
authors.initials: JT
authors.lastname: Pelleter
authors.forename: Axel
authors.initials: A
authors.lastname: Müller
authors.forename: Annett I
authors.initials: AI
authors.lastname: Kröttinger
authors.forename: Oliver
authors.initials: O
authors.lastname: Schöffski
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000191:economics* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000191:economics; D057285:Precision Medicine / Q000191:economics*; D012189:Retrospective Studies; D012648:Self Care / Q000191:economics*; D017216:Telemedicine / Q000191:economics*