SAFE@HOME: Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia
van den Heuvel, Josephus F.M.; van Lieshout, Christiaan; Franx, Arie; Frederix, Geert; Bekker, Mireille N.
(2021) Pregnancy Hypertension, volume 24, pp. 118 - 123
(Article)
Abstract
OBJECTIVE: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia. STUDY DESIGN: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac
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or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring. MAIN OUTCOME MEASURES: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence. RESULTS: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 - 5329] vs €4504 [IQR 3515-6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338-10,173] vs €9150, [IQR 7546-12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources. CONCLUSION: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.
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Keywords: Adult, Blood Pressure Determination, Blood Pressure Monitoring, Ambulatory/economics, Blood Pressure/physiology, Case-Control Studies, Costs and Cost Analysis, Female, Health Care Costs, Humans, Hypertension/epidemiology, Patient Satisfaction, Pre-Eclampsia/diagnosis, Pregnancy, Pregnancy Complications/epidemiology, Prenatal Care/economics, Telemedicine/economics, Journal Article
ISSN: 2210-7789
Publisher: Elsevier BV
Note: Funding Information: None. JFH, CL, GF and MNB designed the study. JFH and MNB were responsible for the acquisition and interpretation of the data. JFH, CL, AF and MNB drafted the manuscript. All authors edited and revised the manuscript. All authors have read and approved the final version of the manuscript. This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). This study was submitted to the Medical Ethics Committee of the University Medical Center in Utrecht (17/424). The committee judged that the Dutch Medical Research Involving Human Subjects Act (WMO) did not apply to this study. Funding Information: This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). Publisher Copyright: © 2021 The Authors Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.
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