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Evaluating a remote patient monitoring program for automated peritoneal dialysis

医学 腹膜透析 作业成本法 急诊医学 队列 重症监护医学 透析 外科 内科学 业务 营销
作者
J.G. Ariza,Surrey M. Walton,Mauricio Sanabria,Alfonso Bunch,Jasmín Vesga,Ángela Rivera
出处
期刊:Peritoneal Dialysis International [SAGE]
卷期号:40 (4): 377-383 被引量:21
标识
DOI:10.1177/0896860819896880
摘要

Background: The benefits of automated peritoneal dialysis (APD) have been established, but patient adherence to treatment remains a concern. Remote patient monitoring (RPM) programs are a potential solution; however, the cost implications are not well established. This study modeled, from the payer perspective, expected net costs and clinical consequences of a novel RPM program in Colombia. Methods: Amarkov model was used to project costs and clinical outcomes for APD patients with and without RPM. Clinical inputs were directly estimated from Renal Care Services data or taken from the literature. Dialysis costs were estimated from national fees. Inpatient costs were obtained from a recent Colombian study. The model projected overall direct costs and several clinical outcomes. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were also conducted to characterize uncertainty in the results. Results: The model projected that the implementation of an RPM program costing US$35 per month in a cohort of 100 APD patients over 1 year would save US$121,233. The model also projected 31 additional months free of complications, 27 fewer hospitalizations, 518 fewer hospitalization days, and 6 fewer peritonitis episodes. In the DSA, results were most sensitive to hospitalization rates and days of hospitalization, but cost savings were robust. The PSA found there was a 91% chance for the RPM program to be cost saving. Conclusion: The results of the model suggest that RPM is cost-effective in APD patients which should be verified by a rigorous prospective cost analysis.

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