Abstract
Introduction
Few data are available on actual follow-up costs of remote monitoring (RM) of implantable defibrillators (ICD). Our study aimed at assessing current direct costs of 1-year ICD follow-up based on RM compared with conventional quarterly in-hospital follow-ups.
Methods and results
Patients (N = 233) with indications for ICD were consecutively recruited and randomized at implant to be followed up for 1 year with standard quarterly in-hospital visits or by RM with one in-hospital visit at 12 months, unless additional in-hospital visits were required due to specific patient conditions or RM alarms. Costs were calculated distinguishing between provider and patient costs, excluding RM device and service cost. The frequency of scheduled in-hospital visits was lower in the RM group than in the control arm. Follow-up required 47 min per patient/year in the RM arm versus 86 min in the control arm (p = 0.03) for involved physicians, generating cost estimates for the provider of USD 45 and USD 83 per patient/year, respectively. Costs for nurses were comparable. Overall, the costs associated with RM and standard follow-up were USD 103 ± 27 and 154 ± 21 per patient/year, respectively (p = 0.01). RM was cost-saving for the patients: USD 97 ± 121 per patient/year in the RM group versus 287 ± 160 per patient/year (p = 0.0001).
Conclusion
The time spent by the hospital staff was significantly reduced in the RM group. If the costs for the device and service are not charged to patients or the provider, patients could save about USD 190 per patient/year while the hospital could save USD 51 per patient/year.
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Acknowledgments
The authors would like to thank Xenia Antoniou (Biotronik SE KG & Co. Berlin, Germany) for her kind assistance in the manuscript review.
Author contributions
All co-authors have substantially contributed to the study conduct and paper draft and approved this manuscript
Leonardo Calò: concept/design, data analysis/interpretation, drafting of article, critical revision of article, approval of article.
Alessio Gargaro: data analysis/interpretation, drafting of article, statistics
Ermenegildo De Ruvo: concept/design, data analysis/interpretation, drafting of article, critical revision of article, approval of article, data collection
Gabriele Palozzi: concept/design, data analysis/interpretation, critical revision of article, approval of article, statistics
Luigi Sciarra: critical revision of article, approval of article, data collection
Marco Rebecchi: critical revision of article, approval of article, data collection
Fabrizio Guarracini: critical revision of article, approval of article, data collection
Alessandro Fagagnini: critical revision of article, approval of article, data collection
Enrico Piroli: data analysis/interpretation, critical revision of article, approval of article
Ernesto Lioy: data analysis/interpretation, critical revision of article, approval of article
Antonio Chirico: concept/design, data analysis/interpretation, critical revision of article, approval of article
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No financial support was received. AG is an employee of Biotronik Italia. The other authors have no conflict of interest to disclose.
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Calò, L., Gargaro, A., De Ruvo, E. et al. Economic impact of remote monitoring on ordinary follow-up of implantable cardioverter defibrillators as compared with conventional in-hospital visits. A single-center prospective and randomized study. J Interv Card Electrophysiol 37, 69–78 (2013). https://doi.org/10.1007/s10840-013-9783-9
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DOI: https://doi.org/10.1007/s10840-013-9783-9