TELEMEDICINE AND e-HEALTH
Volume 12, Number 2, 2006
© Mary Ann Liebert, Inc.
Original Research
Cost-Minimization Analysis of a Telehomecare
Program for Patients with Chronic Obstructive
Pulmonary Disease
GUY PARÉ, Ph.D.,
1
CLAUDE SICOTTE, Ph.D.,
2
DANIELLE ST.-JULES, R.N., M.Sc.,
3
and RICHARD GAUTHIER, M.D.
3
ABSTRACT
A cost-minimization analysis was performed on a telehomecare program for patients with a
chronic obstructive pulmonary disease (COPD). The research was quasi-experimental and in-
cluded a control group. We compared the effects and costs of care provided to a group of 19
patients under a telehomecare program to a comparable group of 10 patients receiving regu-
lar home care without telemonitoring.
Our results clearly indicate that there were fewer home visits by nurses and hospitaliza-
tions for patients in the experimental group. However, these patients made more telephone
calls than patients in the control group, although this difference was not statistically signif-
icant. Of utmost importance, the cost-minimization analysis yielded positive results. Indeed,
telemonitoring over a 6-month period generated $355 in savings per patient, or a net gain of
15% compared to traditional home care.
Our study confirms the findings of previous studies that analyzed the efficacy of tele-
monitoring for patients with COPD. Patients were found to easily accept the idea of using
the technology, and the telehomecare program demonstrated significant clinical benefits. Fi-
nancial advantages of the program could have been more pronounced had it not been for the
cost of technology that effectively erased a good portion of the savings.
1
HEC Montreal, Quebec, Canada.
2
University of Montreal, Quebec, Canada.
3
Maisonneuve Rosemont Hospital, Montreal, Quebec Canada.
INTRODUCTION
C
HRONIC OBSTRUCTIVE PULMONARY DISEASE
(COPD) is a long-term illness characterized
by breathing difficulties that are accompanied
by a progressive deterioration of functional ca-
pacity. Home care for patients with COPD en-
sures a better quality of life and prevents hos-
pitalizations. In recent years, it has become
common for patients with COPD to be given
an expanded role in their own treatment.
1,2
This therapeutic approach generally consists
of patients managing the use of prophylactic
medication and following personalized treat-
ment plans in the home. Clinical studies have
shown that this therapeutic strategy is associ-
ated with significant improvements seen in
both clinical results and quality of life.
3,4
Re-
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