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Published on: October 13, 2016
Tele-assistance in patients with amyotrophic lateral sclerosis: long term activity and costs
Michele Vitacca1, Laura Comini, Giuliano Assoni
1Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, IRCCS, Lumezzane (BS), Italy. michele.vitacca@fsm.it
Purpose:
To describe i) nurse's utilisation and associated costs during 4-year tele-assistance in amyotrophic lateral sclerosis (ALS) ii) optimal time for initiating tele-assistance.
Method:
73 ALS patients after hospital discharge were followed up on voice by phone calls conducted by a nurse through a clinical card which was tested for feasibility, efficacy and utility. Number of patients simultaneously assisted/month, calls/patient, fixed and variable costs were calculated.
Results:
Time between disease's diagnosis and the beginning of tele-assistance was 720 ± 971 days. ALS patients' percentage managed by nurses through tele-assistance increased over time by 628%. Tele-assistance integrated care (TAIC) followed up patients with a total of 5073 telephone calls. Steady state activity was reached at the 3rd year employing 5 ± 3 calls/pt/month (time/call 64 ± 44 min). Implementing the card was feasible, useful and effective by operator. Survival from diagnosis of ALS was 1224 ± 1150 days. Survival was related to tracheotomy.
Conclusion:
TAIC is a feasible tool to manage up to 25 ALS patients/month/nurse and costs about €105.00 per patient per month. Tele-assistance is proposed at 2/3 of time course of the disease.
