Background: Telemedical programs for patients with chronic heart failure have shown inconsistent effects on\nsurvival and hospitalization. Few studies analyzed effects of telemedical interventions on health costs, although this\noutcome may determine whether or not a successful program will be adopted by health insurance providers. We\nevaluated a large sized telemedicine program provided by a German statutory health insurance, consisting of\nregular telephone contacts and, for a subgroup of the participants, provision of an electronic scale in a routine care\nsetting. We examined the effects of the program on the total healthcare costs after one year compared to a\nmatched control group.\nMethods: The evaluation was based on reimbursement data of the statutory health insurance. Participants of the\nprogram were matched to appropriate controls using a combination of exact (e.g. 5-year age group, gender, NYHA class)\nand propensity score (e.g. medication, psychiatric comorbidity) matching.\nThe total health costs after one year were calculated on the basis of regression analyses in an intention-to-treat-approach.\nIn a sensitivity analysis, the subgroup of patients with a documented beginning of the intervention was examined.\nResults: Two thousand six hundred twenty two patients with chronic heart failure (55% male, mean age: 73.7 years)\nwere included in the intervention program. 1943 participants (74%) could be matched with appropriate control patients.\nThe telemedicine monitoring program for patients with chronic heart failure reduced total health costs after 12 months\nof the intervention: âË?â?? 276ââ??¬ per quarter year in rural regions and âË?â?? 18ââ??¬ in urban regions compared to the control group.\nConclusions: The telemedicine program could reduce total health costs, especially in rural regions in Germany.
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