Long-term cost-utility analysis of remote monitoring of older patients with pacemakers: the PONIENTE study
Por:
Bautista-Mesa RJ, Lopez-Villegas A, Peiro S, Catalan-Matamoros D, Robles-Musso E, Lopez-Liria R and Leal-Costa C
Publicada:
16 nov 2020
Ahead of Print:
16 nov 2020
Categoría:
Geriatrics and gerontology
Resumen:
Background Cost-effectiveness studies on pacemakers have increased in the last years. However the number of long-term cost-utility studies is limited. The objective of this study was to perform a cost-utility analysis comparing remote monitoring (RM) versus conventional monitoring (CM) in hospital of older patients with pacemakers, 5 years after implant. Methods Under a controlled, not randomized, nor masked clinical trial, 83 patients with pacemakers were initially selected. After five years of follow-up, a total of 55 patients (CM = 34; RM = 21) completed the study. A cost-utility analysis of RM in terms of costs per gained quality-adjusted life years (QALYs) was conducted. The costs from the Public Health System (PHS) as well as patients and their relatives were taken into account for the study. The robustness of the results was verified by the probabilistic analyses through Monte-Carlo simulations. Results After a five-year follow-up period, total costs were lower in the RM group by 23.02% than in the CM group (euro274.52 versus euro356.62; p = 0.033) because of a cost saving from patients' perspective (euro59.05 versus euro102.98; p = 0.002). However, the reduction of in-hospital visits derived from RM exhibited insignificant impact on the costs from the PHS perspective, with a cost saving of 15.04% (euro215.48 vs. euro253.64; p = 0.144). Costs/QALYs obtained by the RM group were higher as compared to the CM group, although there were no significant differences. The incremental cost-effectiveness ratio of CM in comparison to RM became positive (euro301.16). Conclusions This study confirms RM of older patients with pacemakers appears still as a cost-utility alternative to CM in hospital after 5 years of follow-up.
Filiaciones:
Bautista-Mesa RJ:
Management Unit, Hospital de Poniente, El Ejido, Almeria, Spain
Lopez-Villegas A:
Social Involvement of Critical and Emergency Medicine, CTS-609 Research Group, Hospital de Poniente, El Ejido, s/n, 04700, Almeria, Spain.
:
Health Services Research Unit, FISABIO-PUBLIC HEALTH, Valencia, Spain
Catalan-Matamoros D:
Department of Communication Studies, University Carlos III of Madrid, Madrid, Spain
Health Sciences CTS-451 Research Group, University of Almería, Almería, Spain
Robles-Musso E:
Pacemaker Unit, Intensive Care Unit, Hospital de Poniente, El Ejido, Almería, Spain
Lopez-Liria R:
Department of Nursing Science, Physiotherapy and Medicine, Hum-498 Research Team, Health Research Centre, University of Almería, Almería, Spain
Leal-Costa C:
Nursing Department, University of Murcia, Murcia, Spain
gold, Green Published
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