UNASSIGNED: Telemonitoring improves clinical outcomes in patients with arterial hypertension (AH) and type 2 diabetes (T2D), however, cost structure analyses are lacking. This study seeks to explore the cost structure of telemonitoring for the elderly with AH and T2D in primary care and identify factors influencing
costs for potential future expansions.
UNASSIGNED: Infrastructure, operational, patient participation, and out-of-pocket
costs were determined using a bottom-up approach. Infrastructure costs were determined by dividing equipment and telemonitoring platform expenses by the number of participants. Operational and patient participation costs were determined by considering patient training time, data measurement/review time, and teleconsultation time. The change in out-of-pocket costs was assessed in both groups using a structured questionnaire and 12-month expenditure data. Statistical analysis employed an unpaired sample t-test, Mann-Whitney U test, and chi-square test.
UNASSIGNED: A total of 117 patients aged 71.4±4.7 years were included in the study. The telemonitoring intervention incurred an annual infrastructure
costs of €489.4 and operational
costs of €97.3 (95% CI 85.7-109.0) per patient. Patient annual participation
costs were €215.6 (95% CI 190.9-241.1). Average annual out-of-pocket
costs for both groups were €345 (95% CI 221-469). After 12 months the telemonitoring group reported significantly lower out-of-pocket costs (€132 vs. €545, p<0.001), driven by reduced spending on food, dietary supplements, medical equipment, and specialist check-ups compared to the standard care group.
UNASSIGNED: To optimise the cost structure of telemonitoring, strategies like shortening the telemonitoring period, developing a national telemonitoring platform, using patient devices, integrating artificial intelligence into platforms, and involving nurse practitioners as telemedicine centre coordinators should be explored.
UNASSIGNED: Telemonitoring predstavlja učinkovit pristop za izboljšanje urejenosti bolnikov z arterijsko hipertenzijo (AH) in sladkorno boleznijo (SB) tipa 2, vendar analize stroškovne strukture niso na voljo. Namen raziskave je raziskati stroškovno strukturo telemonitoringa pri starejših bolnikih z AH in SB tipa 2 v primarnem zdravstvenem varstvu in ugotoviti dejavnike, ki vplivajo na stroške za morebitne prihodnje širitve.
UNASSIGNED: S pomočjo pristopa od spodaj navzgor smo ocenili infrastrukturne in operativne stroške, stroške sodelovanja bolnikov in stroške iz žepa. Infrastrukturne stroške smo izračunali tako, da smo stroške nakupa telemedicinske opreme in spletne platforme delili s številom sodelujočih bolnikov. Operativne stroške in stroške sodelovanja bolnikov smo izračunali z upoštevanjem časa za usposabljanje bolnikov, časa za pregled/opravljanje meritev ter časa za telekonzultacije. Spremembe v stroških iz žepa smo ocenili s pomočjo strukturiranega vprašalnika, v katerem so bolniki v obeh skupinah poročali o stroških iz žepa v preteklem letu. Pri statistični analizi smo uporabili t-test za neparne vzorce, Mann-Whitneyev U test in hi-kvadrat test.
UNASSIGNED: V raziskavo je bilo vključenih 117 bolnikov, starih povprečno 71,4 ± 4,7 leta. Letni infrastrukturni stroški telemonitoringa so znašali 489,4 €, operativni stroški pa 97,3 € (95 % interval zaupanja [IZ] 85,7–109,0) na bolnika. Letni stroški sodelovanja bolnikov so znašali 215,6 € (95 % IZ 190,9-241,1). Povprečni letni stroški iz žepa za obe skupini so znašali 345 € (95 % IZ 221-469). Po 12 mesecih je skupina s telemonitoringom poročala o bistveno nižjih stroških iz žepa (132 € proti 545 €, p < 0,001), pri čemer so se pomembno zmanjšali stroški za hrano in prehranska dopolnila, medicinsko opremo in samoplačniške specialistične preglede.
UNASSIGNED: Za optimizacijo stroškovne strukture telemonitoringa je potrebno preučiti strategije, kot so skrajšanje obdobja telemonitoringa po stabilizaciji kliničnih parametrov, razvoj nacionalne platforme za spremljanje na daljavo z možnostjo prenosa mobilne aplikacije na osebne naprave bolnikov, vključevanje umetne inteligence v spletne platforme in povečanje vloge diplomirane medicinske sestre na mestu koordinatorja telemedicinskega centra.