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Alami S, Courouve L, Lancman G, Gomis P, Al-Hamoud G, Laurelli C, Pasche H, Chatellier G, Mercier G, Roubille F, Delval C, Durand-Zaleski I. Organisational Impact of a Remote Patient Monitoring System for Heart Failure Management: The Experience of 29 Cardiology Departments in France. Int J Environ Res Public Health 2023; 20:4366. [PMID: 36901372 PMCID: PMC10002348 DOI: 10.3390/ijerph20054366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Remote patient monitoring (RPM) for the management of patients with chronic heart failure (CHF) has been widely studied from clinical and health-economic points of view. In contrast, data on the organisational impact of this type of RPM are scarce. The objective of the present study of cardiology departments (CDs) in France was to describe the organisational impact of the Chronic Care ConnectTM (CCCTM) RPM system for CHF. An organisational impact map for health technology assessment was used to identify and define the criteria evaluated in the present survey, including the care process, equipment, infrastructure, training, skill transfers, and the stakeholders' abilities to implement the care process. In April 2021, an online questionnaire was sent to 31 French CDs that were using CCCTM for CHF management: 29 (94%) completed the questionnaire. The survey results showed that CDs progressively modified their organisational structures upon or shortly after the implementation of the RPM device. Twenty-four departments (83%) had created a dedicated team, sixteen (55%) had provided dedicated outpatient consultations for patients with an emergency alert, and twenty-five (86%) admitted patients directly (i.e., avoiding the need to attend the emergency department). The present survey is the first to have assessed the organisational impact of the implementation of the CCCTM RPM device for CHF management. The results highlighted the variety of organisational structures, which tended to structure with the use of the device.
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Affiliation(s)
- Sarah Alami
- ALSI, Air Liquide Santé International, 92220 Bagneux, France
| | | | - Guila Lancman
- ALSI, Air Liquide Santé International, 92220 Bagneux, France
| | | | | | | | - Hélène Pasche
- ALSI, Air Liquide Santé International, 92220 Bagneux, France
| | - Gilles Chatellier
- Department of Statistics Informatics and Public Health, Université Paris-Cité, 75006 Paris, France
- Clinical Research Unit, Groupe Hospitalier Paris Saint Joseph, 75014 Paris, France
| | - Grégoire Mercier
- Economic Evaluation Unit (URME), University Hospital of Montpellier, 34295 Montpellier, France
- IDESP, Université de Montpellier, INSERM, 34000 Montpellier, France
| | - François Roubille
- Cardiology Department, Hôpital Lapeyronie, PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, INI-CRT, 34090 Montpellier, France
| | - Cécile Delval
- ALSI, Air Liquide Santé International, 92220 Bagneux, France
| | - Isabelle Durand-Zaleski
- Université de Paris, CRESS, INSERM, INRA, URCEco, AP-HP, Hôpital de l’Hôtel Dieu, 75004 Paris, France
- Santé Publique Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny F, 94010 Créteil, France
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Pathak A, Levy P, Roubille F, Chatellier G, Mercier G, Alami S, Lancman G, Pasche H, Laurelli C, Delval C, Ramirez‐Gil JF, Galinier M. Healthcare costs of a telemonitoring programme for heart failure: indirect deterministic data linkage analysis. ESC Heart Fail 2022; 9:3888-3897. [PMID: 35950267 PMCID: PMC9773639 DOI: 10.1002/ehf2.14072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/01/2022] [Accepted: 06/21/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS We aim to evaluate the costs associated with healthcare resource consumption for chronic heart failure (HF) management in patients allocated to telemonitoring versus standard of care (SC). METHODS AND RESULTS OSICAT-ECO involved 745 patients from the OSICAT trial (NCT02068118) who were successfully linked to the French national healthcare database through an indirect deterministic data linkage approach. OSICAT compared a telemonitoring programme with SC follow-up in adults hospitalized for acute HF ≤ 12 months. Healthcare resource costs included those related to hospital and ambulatory expenditure for HF and were restricted to direct costs determined from the French health data system over 18 months of follow-up. Most of the total costs (69.4%) were due to hospitalization for HF decompensation, followed by ambulatory nursing fees (11.8%). During 18-month follow-up, total costs were 2% lower in the telemonitoring versus the SC group, due primarily to a 21% reduction in nurse fees. Among patients with NYHA class III/IV, a 15% reduction in total costs (€3131 decrease) was observed over 18-month follow-up in the telemonitoring versus the SC group, with the highest difference in hospital expenditure during the first 6 months, followed by a shift in costs from hospital to ambulatory at 12 months. CONCLUSIONS HF hospitalization and ambulatory nursing fees represented most of the costs related to HF. No benefit was observed for telemonitoring versus SC with regard to cost reductions over 18 months. Patients with severe HF showed a non-significant 15% reduction in costs, largely related to hospitalization for HF decompensation, nurse fees, and medical transport.
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Affiliation(s)
- Atul Pathak
- Department of Cardiovascular MedicinePrincess Grace HospitalMonacoPrincipality of Monaco
| | - Pierre Levy
- LEDa – LEGOS, Université Paris DauphinePSL Research UniversityParisFrance
| | - François Roubille
- Cardiology Department, INI‐CRT, CHU de Montpellier, PhyMedExpUniversité de Montpellier, INSERM, CNRSMontpellierFrance
| | - Gilles Chatellier
- Clinical Research Unit and CIC 1418 INSERMGeorge‐Pompidou European HospitalParisFrance
| | - Grégoire Mercier
- Economic Evaluation Unit (URME), University Hospital of MontpellierMontpellier UniversityMontpellierFrance,IDESPUniv Montpellier, INSERMMontpellierFrance
| | - Sarah Alami
- Air Liquide Santé InternationalBagneuxFrance
| | | | | | | | | | | | - Michel Galinier
- Cardiology DepartmentRangueil University HospitalToulouseFrance,Faculty of MedicineUniversity of Paul Sabatier‐Toulouse IIIToulouseFrance
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