Remote Continuous Vital Sign Monitoring of Scoliosis Surgery Patients on General Wards: A Cost-Effectiveness Analysis.

Abstract

BACKGROUND Scoliosis surgery patients often require continuous postoperative monitoring in intensive care (ICU) or high-dependency units (HDU). We implemented a 24-hour remote continuous monitoring service for high-risk inpatients (HIVE) to allow monitoring in general wards. This study aimed to evaluate the cost-effectiveness of the HIVE service. METHODS We compared scoliosis surgery patients admitted pre- and postimplementation of the HIVE service and applied multivariable regression to adjust for differences in baseline characteristics. The primary outcome was incremental cost per ICU hour avoided. RESULTS We compared 155 patients admitted postimplementation to 133 admitted preimplementation. In the adjusted analysis, the post-HIVE implementation period avoided 27.1 hours in ICU and reduced overall health care costs by AU$2682 (US$2164) per patient, compared with preimplementation. There were no statistically significant differences in hospital length of stay (rate ratio [RR], 1.01; 95% confidence interval [CI], 0.93-1.11; P = .785), emergency readmissions (odds ratio [OR], 0.93; 95% CI, 0.44-1.99; P = .854), or hospital-acquired complications (OR, 0.68; 95% CI, 0.27-1.66; P = .393). CONCLUSIONS In scoliosis surgery, the implementation of a remote continuous inpatient monitoring service reduced inpatient costs and hours in ICU. In this group of patients, the HIVE service provides economic evidence of the cost-effectiveness of remote monitoring.