Days at Home for Older Adults Receiving a Remote Monitoring Intervention Compared with Usual Home Care Recipients

Abstract

Objectives

Many older adults will experience physical and or cognitive decline, limiting their ability to live independently. To better support these individuals, remote monitoring programs use technology to track patient falls, location, and medication adherence. Our main objective was to compare outcomes of patients enrolled in a remote monitoring program with matched individuals who received home care.

Design

Propensity score–matched cohort study.

Setting and Participants

Toronto, Ontario, Canada. Older adults (aged 65 or older) in a remote monitoring program (N = 1587) compared with a control group of older adults initiating a new episode of home care (N = 33,207).

Methods

The primary outcome was days spent at home in the following 100 days. Additional outcomes included days in different health care settings, days alive, and health care costs.

Results

Before matching, patients enrolled in the remote monitoring program (946 female) were younger [mean (SD) = 80.1 years (8.2) vs 82.4 (8.5), standardized mean difference 0.21] than those in the home care group (20,877 female). After matching, there were 1494 individuals in each group. In the 100 days following the index date, those in the remote monitoring group spent 3.4 more days at home than the home care group (92.3 vs 88.9 days, 95% CI, 1.9–5.0 days; rate ratio, 1.04; 95% CI, 1.02–1.06). This was attributable to more days alive (98.6 vs 96.4 days; 95% CI, 1.3–3.1 days; rate ratio, 1.03; 95% CI, 1.01–1.03). In addition, the remote monitoring group had lower health care costs overall (difference of $1635.54 CAD, 95% CI, $228.83–$3087.11).

Conclusions and Implications

Individuals enrolled in a remote monitoring program spent more days at home compared with those who received home care services, mainly attributed to more days alive. Further study is needed to confirm our findings; however, remote monitoring is a promising solution to support older adults with high care needs.