Assessment of the Clinical Outcomes and Cost-Effectiveness of the Management of Systolic Heart Failure in Chinese Patients Using a Home-Based Intervention

Abstract

This study was designed to assess the clinical effect of a home-based telephone intervention in Chinese heart failure patients. A total of 550 Chinese heart failure patients were enrolled into either (i) a group that received the usual standard of care (UC group); or (ii) a group that received a home-based heart failure centre management programme using nursing specialist-led telephone consultations (HFC group). The impact of the home-based intervention on admission rate, admission length and medical costs over 6 months was measured. Although the mean left ventricular ejection fraction in HFC patients was 29.3% compared with 34.8% in UC patients, the home-based intervention resulted in a significantly lower all-cause admission rate per person (HFC 0.60 ± 0.77 times/person; UC 0.96 ± 0.85 times/person), a shorter all-cause hospital stay (reduced by 8 days per person) and lower total 6-month medical costs (reduced by US$2682 per patient). These results suggest that the home-based intervention with nursing specialist-led telephone consultations may improve the clinical outcome and provide cost-savings for Chinese patients with heart failure.

Cost-Effectiveness of Telehealth Interventions for Chronic Heart Failure Patients: A Literature Review

“…Twenty-five articles originated from the United States, two from Australia (19;20), two from Italy (34;35), one from the United Kingdom (36), one from China (28), and one from Taiwan (33). Twenty-five articles originated from the United States, two from Australia (19;20), two from Italy (34;35), one from the United Kingdom (36), one from China (28), and one from Taiwan (33).…”

“…One paper each reported on the evaluation of RCT (20), a stratified randomization design(25), concurrent matchedcohort(27), nonconcurrent prospective design(28), prospective 301 articles identified for abstract reading 190 articles out on the basis of:23 -Telehealth not as main intervention 23 -Heart Failure not as main disease 127 -Economic analysis not present 17 -Review article (not a primary analysis)111 articles selected for full text reading 66 articles out after double assessment. Regarding the design, twenty-one papers reported on the RCT design and two on quasi-experimental design(22;26).…”

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

“…Similar findings were reported from a 2010 study in China in which 550 heart failure patients were randomized to an intervention consisting of nursing telephone consultations versus a control group receiving the usual standard of care. 56 After 6 months, the intervention group had a significantly lower all-cause admission rate, a shorter all-case hospital stay (8 days fewer per patient), and overall lower total cost. A multicenter RCT (n = 382) was conducted in The Netherlands in 2012 to ascertain the effects of telemonitoring on heart failure hospitalization over a 1-year follow-up period.…”

Web-Based Medical Service: Technology Attractiveness, Medical Creditability, Information Source, and Behavior Intention

“…Web-based medical services (WBMS) such as eHealth, mHealth, and telehealth seem feasible solutions [ 6 , 7 ]. WBMS is considered as one of the most innovative services in medical technology in the 21 st century [ 8 ]; however, promoting these services is still a challenge [ 5 ]. There are 3 impediments: perceived usefulness, behavior change, and medical law limitation.…”