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A Telemonitoring Intervention for Cirrhotic Ascites Management Is Cost-Saving
Patricia P Bloom1, Martin Ventoso2, Elliot Tapper3
1Gastrointestinal Unit, University of Michigan, Taubman Center, Floor 1, Reception G, 1500 E. Medical Center Dr., Ann Arbor, MI, USA. ppbloom@med.umich.edu.
Digestive Diseases and Sciences
|May 21, 2021
Summary
Telemonitoring for cirrhotic ascites significantly reduces healthcare costs and hospital admissions compared to standard care. This approach improves patient outcomes through proactive interventions and more frequent large volume paracenteses.
Area of Science:
- Hepatology
- Health Economics
- Digital Health
Background:
- Cirrhosis with ascites leads to frequent hospitalizations, impacting patient quality of life and increasing healthcare expenditures.
- Current ascites management includes weight monitoring, but telemonitoring may offer improved outcomes and cost-effectiveness.
Purpose of the Study:
- To evaluate the cost-effectiveness and clinical outcomes of a telemonitoring system versus usual care for patients with cirrhotic ascites.
Main Methods:
- A decision-analytic model simulating 100 patients over a 6-month period was developed.
- Usual care was compared against a novel telemonitoring program, with an estimated cost of $50,000 per 6 months.
Main Results:
- Standard care for cirrhotic ascites is $167,500 more expensive than telemonitoring over 6 months for 100 patients.
- Sensitivity analyses confirmed standard care's higher cost, ranging from $9,400 to $340,200 more expensive.
- Telemonitoring reduced admissions by 9 (4-12) but increased outpatient visits by 9 (6-9) and large volume paracenteses (LVPs) by 28 (17-28).
Conclusions:
- Telemonitoring interventions are cost-saving in the management of cirrhotic ascites across most scenarios.
- Improved patient outcomes, indicated by reduced hospital admissions, are achieved through proactive interventions and increased LVPs with telemonitoring.
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