Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system

Abstract

Purpose-To estimate the costs and cost-effectiveness of a tele-ICU program.Materials and methods-We used an observational study with ICU patients cared for during the pre-tele-ICU period and ICU patients cared for during the post-tele-ICU period in 6 ICUs at 5 hospitals, part of a large non-profit health care system in the Gulf Coast region. We obtained data on a sample of 4142 ICU patients: 2,034 in the pre-tele-ICU period and 2,108 in the post-tele-ICU period. Economic outcomes were hospital costs, ICU costs and floor costs, measured for average daily costs, costs per case, and costs per patient.

Voices of Family Members and Significant Others in the Tele–Intensive Care Unit

“…The study was approved by the institutional review boards at each of the 3 participating health systems. 15 Franzini et al 16 Zawada et al 17 Young .007…”

“…15 A shorter length of stay (LOS) was evident for the tele-ICU at 3.63 days (95% CI, 3.21-4.04 days) compared with 4.35 days (95% CI, 3.93-4.78 days; P<.05) in the traditional ICUs. 15 In an observational study, 16 the clinical impact and costs of critical care provided before and after implementation of a tele-ICU program in 6 ICUs in a large health care system were compared. There was a significant 11.4% reduction in mortality rates (P<.05) and a nonsignificant increase of $2985 (P>.05) in costs of care per patient for the most ill patients after implementation of the tele-ICU.…”

“…There was a significant 11.4% reduction in mortality rates (P<.05) and a nonsignificant increase of $2985 (P>.05) in costs of care per patient for the most ill patients after implementation of the tele-ICU. 16 Mortality rates, ICU LOS, and hospital LOS were compared 1 year before and 2 years after implementation of an ICU telemedicine program at a tertiary-care center. 17 After adjustment for mortality predicted on the basis of scores on the Acute Physiology and Chronic Health Evaluation (APACHE), significantly lower ICU mortality rates were evident during implementation of the tele-ICU (odds ratio, 0.35; P=.007).…”

Perspectivas de la telemedicina como una alternativa para la atención en salud en Honduras

“…La telemedicina ha demostrado tener numerosas aplicaciones en el mundo industrializado, tanto para propósitos clínicos como educativos (Gonzalez-Espada, 2009;Franzini, 2011;Montero, 2011;Duran, 2014). El uso de la telemedicina en países en desarrollo ha mostrado potencial utilidad, pero las aplicaciones clínicas se han enfocado primordialmente en la atención para alivio de desastres (Ayyagari et al, 2003;Wooton, 2008).…”

“…Muchos de estos programas han mostrado tener un costo neutral o mínimo, además de índices de satisfacción favorables para el paciente y el proveedor (Crow et al, 2009;Franzini, 2011). En países subdesarrollados se ha reportado el reto de la mala conectividad del internet, la escasa banda ancha y la estabilidad de la energía eléctrica, pero el potencial de fortalecer el cuidado primario y especializado en áreas remotas a través de la telemedicina, parece vasto.…”