News items Telemonitoring in chronic heart failure not unqualifiedly positive

19 October 2021

To contain rising healthcare costs, digitization of healthcare is often seen as a solution. Researchers at the Radboudumc examined the use of telemonitoring in chronic heart failure. Does this reduce hospital admissions and visits to the emergency room? Sometimes it does, but often not. Sometimes the demand for care and costs even increase. More insight is needed if telemonitoring is to be introduced successfully.

Healthcare costs are rising fast, and in time they will be impossible to meet. Digital healthcare is often seen as a way to limit these rising costs. Researchers at the Radboudumc examined whether this premise is correct using a concrete example: telemonitoring for chronic heart failure. This is not entirely coincidental, as in many 'Western' countries one to two percent of the healthcare budget is spent on this condition. In the Netherlands, where almost a quarter of a million people suffer from chronic heart failure, 30,000 hospital admissions were recorded in 2017. The total care costs for this patient group amounted to 817 million euros.

Remote monitoring

Monitoring the patient at home via digital systems (telemonitoring) is based on the assumption that deterioration of the patient's condition will be detected earlier. This also makes it possible to intervene earlier - with adjustments to medication, for example - so that hospital admissions and visits to the emergency room (ED) are less frequent. That sounds logical, but is it really the case in practice?

Increased demand for care

Based on a systematic review, Stefan Auener, researcher at IQ healthcare of the Radboudumc, concluded that this is usually not the case. Telemonitoring does not show a decrease in the number of hospital admissions in most cases. And in the vast majority of cases, it does not seem to have an effect on the number of emergency room visits. However, there is a wide variety of telemonitoring programs, a minority of which do show clear savings in care use and care costs. "A striking finding is that the majority of studies show an increase in other care use, such as outpatient visits. This is really still understudied and raises many questions that need to be further investigated" says Patrick Jeurissen, Professor of Affordability of Care at the Radboudumc.

Filtering out success factors

The researchers' general conclusion is that the effects of telemonitoring on healthcare costs are still very unclear, and often even contradictory. Most likely this is due to the large variation in telemonitoring programs and target populations. Further research will have to focus more on the how and why of these differences, so that it becomes clear which criteria a successful introduction of telemonitoring must meet. Only in this way can telemonitoring contribute to reducing healthcare costs.

About the publicatie

Publication in Journal of medical internet research: The Effect of Noninvasive Telemonitoring for Chronic Heart Failure on Health Care Utilization: Systematic Review - Stefan L Auener, Toine E P Remers, Simone A van Dulmen, Gert P Westert, Rudolf B Kool, Patrick P T Jeurissen.

 

Related news items


More than five million euros for research to improve palliative care Jeroen Hasselaar will lead research project with Horizon grant

15 June 2022 Jeroen Hasselaar will lead a large international research project. With a 5.3 million euro grant from the EU's Horizon program, he and his team want to improve palliative care for cancer patients, together with partners from nine European countries. read more

Most COVID-19 ICU survivors experience symptoms one year after ICU admission Publication in JAMA

25 January 2022 75% of the COVID-19 survivors who were treated in the Intensive Care Unit (ICU) experience physical, mental and/or cognitive problems one-year post ICU. This shows the large-scale MONITOR-IC study led by Radboudumc. read more

1.4 million euro to reduce hospital admissions due to medication

7 January 2022 A team of sixteen Dutch hospitals received a grant of 1.4 million euros from ZonMw. They will investigate whether they can reduce medication related hospital readmissions. read more

Depressive symptoms during pregnancy affect baby

16 September 2021 Depression or depressive symptoms during pregnancy may lead to a bad start for the infant, such as a preterm birth. Researchers of Radboudumc found that this was true for both women who were treated with antidepressants and those who received no medication. read more

Two million euros for improved treatment and outcomes of COVID-19 in the elderly

10 September 2021 ZonMw awarded a grant of nearly two million euros to a large group of researchers to improve the outcomes of elderly people with COVID-19. The study, in which the Radboudumc also participates, provides insight into the course and treatment of COVID-19 in the elderly. read more