HealthDay News — A telehealth intervention for chronic health conditions improved emergency admission rates and lowered mortality in hospitals in England compared with usual care, study data show.
Adam Steventon, from the Nuffield Trust in London, and colleagues compared telehealth with usual care using information from routine administrative datasets in a multisite, cluster randomized trial. A total of 3,230 individuals with diabetes, chronic obstructive pulmonary disease, or heart failure, recruited from 179 general practices in three areas of England, were allocated to receive telehealth or usual care. Those assigned to the telehealth intervention received care that consisted of remote information exchange between patients and health care professionals.
Overall, the intervention group had a lower proportion of admissions during 12 months of follow-up compared with controls (odds ratio, 0.82; P = 0.017), Steventon and colleagues reported in BMJ. At 12 months, mortality was lower for intervention participants than controls (4.6% vs. 8.3%; OR=0.54). These differences persisted after adjustment.
The mean number of emergency admissions was lower in the intervention group in unadjusted analyses, with the difference significant after adjustment for a predictive risk score but not after adjustment for baseline characteristics. The greatest difference in emergency admissions was seen at the start of the trial, when the control group experienced a large increase. Intervention patients experienced a significantly shorter length of stay. Differences in other forms of hospital use, including costs, were generally not significant.
“Our results suggest that telehealth helped patients to avoid the need for emergency hospital care,” the researchers. “Further analyses will provide insights into the mechanisms by which telehealth can lead to reductions in admission rates.”
Steventon A et al. BMJ. 2012;344:e3874