EPOCA Telemonitoring System in Older Adults at High Risk for Hospitalization in France: Budget Impact and...

Area of Science:

• Gerontology
• Health Economics
• Medical Technology

Background:

• France's aging population experiences high chronic illness rates, multimorbidity, and avoidable hospitalizations, straining the healthcare system.
• Remote monitoring systems (RMS) show potential for enhancing care coordination and reducing acute care utilization.

Purpose of the Study:

• To evaluate the cost-effectiveness of the EPOCA RMS within the Vigie-Age framework compared to standard care (SOC) for elderly individuals with multiple chronic conditions.

Main Methods:

• A 10-year cost-utility analysis using a Markov model with daily cycles, based on the Vigie-Age Article 51 pilot study data (722 participants).
• Simulated transitions across health states including home, emergency department (ED) visits, hospitalization, and death.
• Analyzed costs from French National Health Insurance (NHI) and collective perspectives, including direct medical costs and quality-adjusted life years (QALYs).

Main Results:

• EPOCA reduced ED visits by 54% and hospitalizations by 46%, decreasing average hospital stay from 55.6 to 30.6 days.
• Total costs per patient were €10,764 lower from the collective perspective (€29,165 with EPOCA vs. €39,929 for SOC) and €7,430 lower from the NHI perspective.
• EPOCA yielded 0.04 additional QALYs and demonstrated a 95% probability of being cost-effective at a €30,000/QALY threshold.

Conclusions:

• EPOCA presents a potentially cost-effective strategy for elderly patients at high risk of hospitalization.
• The system may decrease healthcare utilization while simultaneously improving patient outcomes.
• Supports EPOCA's integration into national elderly care pathways and French NHI reimbursement.