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Presentation

Session: Alternate Care
Room: Chydenius Rooms
Time: Thu 16:00-17:15

Presenter: Iben Fasterholdt (Odense University Hospital. Department for Research and HTA)

Abstract

Objective
The objective is to assess the economic consequences of a new telemedicine outpatient treatment regime for patients with chronic obstructive pulmonary disease (COPD) introduced at Odense University Hospital in Denmark. Instead of treating patients in the hospital, patients are discharged early with a suitcase equipped with instruments for various clinical measurements and build-in videoconference equipment for communication with a call-center at the hospital.

Methods
As part of a hospital-based HTA the economic consequences of the new treatment were assessed with a business case approach – a framework intended for studying the economic impact of new technologies from a hospital perspective. Cost comparisons were performed including costs related to a reduced number of inpatient days, video-conferenced consultations, investment and running cost of the equipment and the reduced number of readmissions for patients using the suitcase. Sensitivity analyses assessed the importance of central parameters.

The HTA analysis includes also organisational prerequisites, legal issues, patient satisfaction, however, these findings will not be reported here in any details.

Findings
Based on data from an previous trial and expectations for treatment in daily routine settings, the results indicate that the reduced cost of applying the new telemedicine solution, compared to traditional inpatient treatment, covering 21 % of all the COPD-patients at Odense University Hospital equivalent to 326 patients, will be 1.5 million DKK (300,000 US$). Patients enrolled in the telemedicine programme are expected to spend in total 1,414 fewer days in hospital compared to traditional treatment.

The cost savings are especially sensitive to cost of equipment, reduced number of inpatient days at the index admission, number of patients included in the programme, and reduced readmission.

Conclusions
Introduction of home hospitalisation of COPD-patients using telemedicine reduce costs mainly because of the reduced number of readmission and reduced number of inpatient days at the index admission. Sensitivity analysis shows that results are especially sensitive to cost of equipment, reduced number of inpatient days at the index admission, number of patients included in the programme, and reduced readmission.

Key Terms

telemedicine, ehealth, COPD, chronic obstructive pulmonary disease, economic evaluation, HTA, health technology assessment, business case

Authors:

Iben Fasterholdt (Odense University Hospital. Department for Research and HTA) and Mickael Bech (University of Southern Denmark. Institute of Public Health - Health Economics)

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