Assuntos
Equipamentos e Provisões , Tecnologia de Sensoriamento Remoto/métodos , Telemetria/métodos , Austrália , Confidencialidade , Conflito de Interesses/economia , Desfibriladores Implantáveis , Equipamentos e Provisões/economia , Financiamento Governamental/economia , Fidelidade a Diretrizes , Gastos em Saúde , Indústrias/economia , Programas Nacionais de Saúde/economia , Marca-Passo Artificial/economia , Mecanismo de Reembolso/economia , Tecnologia de Sensoriamento Remoto/economia , Telemetria/economiaRESUMO
OBJECTIVE: The present study seeks to conduct cost-utility analysis (CUA) of the Danish TELEKAT (Telehomecare, Chronic Patients and the Integrated Healthcare System) project. The TELEKAT project seeks to test and develop a preventive home monitoring concept across sectors for chronic obstructive pulmonary disease (COPD) patients. The concept of the TELEKAT project is to reduce admissions by enabling the COPD patients to conduct self-monitoring and maintain rehabilitation activities in their own home. COPD patients with severe and very severe COPD were included in the study. SUBJECTS AND METHODS: This economic evaluation follows international guidelines for the conduction of a CUA alongside a clinical randomized controlled trial. The analysis is based on a health sector perspective. RESULTS: The mean incremental cost efficiency ratio, located in the southeast quadrant, shows that telerehabilitation is less costly and more effective than the rehabilitation given to the control group. The telerehabilitation program produces more value for money and generates savings on healthcare budgets. CONCLUSIONS: The telerehabilitation program appears to be more cost-effective than the conventional rehabilitation program for COPD patients. Further studies of cost-effectiveness with a focus on large-scale studies are needed.
Assuntos
Doença Pulmonar Obstrutiva Crônica/reabilitação , Telemetria/economia , Adulto , Idoso , Idoso de 80 Anos ou mais , Custos e Análise de Custo/métodos , Dinamarca , Humanos , Pessoa de Meia-Idade , Monitorização Fisiológica , Inquéritos e QuestionáriosAssuntos
Doença Crônica/prevenção & controle , Planos de Seguro com Fins Lucrativos/economia , Comportamentos Relacionados com a Saúde , Promoção da Saúde/economia , Seguro Saúde/economia , Estilo de Vida , Prevenção Primária/economia , Doença Crônica/economia , Doença Crônica/reabilitação , Análise Custo-Benefício , Gerenciamento Clínico , Financiamento Pessoal/economia , Alemanha , Humanos , Monitorização Fisiológica/economia , Motivação , Programas Nacionais de Saúde/economia , Prevenção Secundária/economia , Telemetria/economia , Prevenção Terciária/economiaRESUMO
A telemedicine service consisting of electrocardiogram (ECG) interpretation and advice on the management of chest pain offshore was offered to oil rig installations in the North Sea. A total of 14 subscribing oil rigs were supplied with thrombolytic drugs and rig paramedics were trained in their delivery. Electrocardiographs could be recorded using a standard ECG machine and then digitized using a scanner for transmission as an email attachment. Several oil companies invested in ECG equipment which allowed direct recording of the patient's ECG in electronic form for transmission by email. Uptake of the telemedicine service was very rapid. The majority of rig medics found the system very easy to use. During a 36-month study period from August 2004, 47 cases of chest pain were dealt with by telemedicine. Of these 47 cases, only six patients (13%) were airlifted to shore. The 41 remaining ECGs did not to have acute changes requiring immediate evacuation. The use of email for ECG transmission proved to be highly effective in managing chest pain offshore.