title: Economic Modeling of Heart Failure Telehealth Programs: When Do They Become Cost Saving?
abstract: Telehealth programs for congestive heart failure have been shown to be clinically effective. This study assesses clinical and economic consequences of providing telehealth programs for CHF patients. A Markov model was developed and presented in the context of a home-based telehealth program on CHF. Incremental life expectancy, hospital admissions, and total healthcare costs were examined at periods ranging up to five years. One-way and two-way sensitivity analyses were also conducted on clinical performance parameters. The base case analysis yielded cost savings ranging from $2832 to $5499 and 0.03 to 0.04 life year gain per patient over a 1-year period. Applying telehealth solution to a low-risk cohort with no prior admission history would result in $2502 cost increase per person over the 1-year time frame with 0.01 life year gain. Sensitivity analyses demonstrated that the cost savings were most sensitive to patient risk, baseline cost of hospital admission, and the length-of-stay reduction ratio affected by the telehealth programs. In sum, telehealth programs can be cost saving for intermediate and high risk patients over a 1- to 5-year window. The results suggested the economic viability of telehealth programs for managing CHF patients and illustrated the importance of risk stratification in such programs.
authors.affiliation: Philips Research North American, Briarcliff Manor, NY 10510, USA.
authors.forename: Sheena Xin
authors.initials: SX
authors.lastname: Liu
authors.affiliation: Columbia University, New York, NY 10027, USA.
authors.forename: Rui
authors.identifier: 0000-0003-3975-0434
authors.initials: R
authors.lastname: Xiang
authors.affiliation: Philips Home Health Services, Framingham, MA 01702, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Lagor
authors.affiliation: Columbia University, New York, NY 10027, USA.
authors.forename: Nan
authors.initials: N
authors.lastname: Liu
authors.affiliation: Dignity Health, Santa Maria, CA 93458, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Sullivan