Ju-Yeh Yang, Yen-Wen Wu, Wenpo Chuang, Tzu-Chun Lin, Shu-Wen Chang, Shou-Hsia Cheng, Raymond N Kuo
{"title":"基于社区的综合血压远程监测项目——一项基于人群的观察性研究。","authors":"Ju-Yeh Yang, Yen-Wen Wu, Wenpo Chuang, Tzu-Chun Lin, Shu-Wen Chang, Shou-Hsia Cheng, Raymond N Kuo","doi":"10.6515/ACS.202209_38(5).20220330A","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Home blood pressure telemonitoring (BPT) has been shown to improve blood pressure control. A community-based BPT program (the <i>Health</i>+ program) was launched in 2015 in an urban area around a medical center.</p><p><strong>Objectives: </strong>To examine the impact of the BPT program on the use of medical resources.</p><p><strong>Methods: </strong>We conducted a retrospective propensity-score (PS)-matched observational cohort study using the National Health Insurance Research Database (NHIRD) 2013-2016 in Taiwan. A total of 9,546 adults with a high risk of cardiovascular disease participated in the integrated BPT program, and 19,082 PS-matched controls were identified from the NHIRD. The primary and secondary outcome measures were changes in 1-year emergency department visit rate, hospitalization rate, duration of hospital stay, and healthcare costs.</p><p><strong>Results: </strong>The number of emergency department visits in the <i>Health</i>+ group significantly reduced (0.8 to 0.6 per year vs. 0.8 to 0.9 per year, p < 0.0001) along with a significant decrease in hospitalization rate (43.7% to 21.3% vs. 42.7% to 35.3%, p < 0.001). The duration of hospital stay was also lower in the <i>Health</i>+ group (4.3 to 3.3 days vs. 5.3 to 6.5 days, p < 0.0001). The annual healthcare costs decreased more in the <i>Health</i>+ group (USD 1642 to 1169 vs. 1466 to 1393 per year, p < 0.001), compared with the controls. Subgroup analysis of the <i>Health</i>+ group revealed that the improvements in outcomes were significantly greater among those who were younger and had fewer comorbidities, especially without diabetes or hypertension.</p><p><strong>Conclusions: </strong>A community-based integrated BPT program may improve patients' health outcomes and reduce healthcare costs.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"38 5","pages":"612-622"},"PeriodicalIF":1.8000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479044/pdf/acs-38-612.pdf","citationCount":"0","resultStr":"{\"title\":\"An Integrated Community-Based Blood Pressure Telemonitoring Program - A Population-Based Observational Study.\",\"authors\":\"Ju-Yeh Yang, Yen-Wen Wu, Wenpo Chuang, Tzu-Chun Lin, Shu-Wen Chang, Shou-Hsia Cheng, Raymond N Kuo\",\"doi\":\"10.6515/ACS.202209_38(5).20220330A\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Home blood pressure telemonitoring (BPT) has been shown to improve blood pressure control. A community-based BPT program (the <i>Health</i>+ program) was launched in 2015 in an urban area around a medical center.</p><p><strong>Objectives: </strong>To examine the impact of the BPT program on the use of medical resources.</p><p><strong>Methods: </strong>We conducted a retrospective propensity-score (PS)-matched observational cohort study using the National Health Insurance Research Database (NHIRD) 2013-2016 in Taiwan. A total of 9,546 adults with a high risk of cardiovascular disease participated in the integrated BPT program, and 19,082 PS-matched controls were identified from the NHIRD. The primary and secondary outcome measures were changes in 1-year emergency department visit rate, hospitalization rate, duration of hospital stay, and healthcare costs.</p><p><strong>Results: </strong>The number of emergency department visits in the <i>Health</i>+ group significantly reduced (0.8 to 0.6 per year vs. 0.8 to 0.9 per year, p < 0.0001) along with a significant decrease in hospitalization rate (43.7% to 21.3% vs. 42.7% to 35.3%, p < 0.001). The duration of hospital stay was also lower in the <i>Health</i>+ group (4.3 to 3.3 days vs. 5.3 to 6.5 days, p < 0.0001). The annual healthcare costs decreased more in the <i>Health</i>+ group (USD 1642 to 1169 vs. 1466 to 1393 per year, p < 0.001), compared with the controls. 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An Integrated Community-Based Blood Pressure Telemonitoring Program - A Population-Based Observational Study.
Background: Home blood pressure telemonitoring (BPT) has been shown to improve blood pressure control. A community-based BPT program (the Health+ program) was launched in 2015 in an urban area around a medical center.
Objectives: To examine the impact of the BPT program on the use of medical resources.
Methods: We conducted a retrospective propensity-score (PS)-matched observational cohort study using the National Health Insurance Research Database (NHIRD) 2013-2016 in Taiwan. A total of 9,546 adults with a high risk of cardiovascular disease participated in the integrated BPT program, and 19,082 PS-matched controls were identified from the NHIRD. The primary and secondary outcome measures were changes in 1-year emergency department visit rate, hospitalization rate, duration of hospital stay, and healthcare costs.
Results: The number of emergency department visits in the Health+ group significantly reduced (0.8 to 0.6 per year vs. 0.8 to 0.9 per year, p < 0.0001) along with a significant decrease in hospitalization rate (43.7% to 21.3% vs. 42.7% to 35.3%, p < 0.001). The duration of hospital stay was also lower in the Health+ group (4.3 to 3.3 days vs. 5.3 to 6.5 days, p < 0.0001). The annual healthcare costs decreased more in the Health+ group (USD 1642 to 1169 vs. 1466 to 1393 per year, p < 0.001), compared with the controls. Subgroup analysis of the Health+ group revealed that the improvements in outcomes were significantly greater among those who were younger and had fewer comorbidities, especially without diabetes or hypertension.
Conclusions: A community-based integrated BPT program may improve patients' health outcomes and reduce healthcare costs.
期刊介绍：
Acta Cardiologica Sinica welcomes all the papers in the fields related to cardiovascular medicine including basic research, vascular biology, clinical pharmacology, clinical trial, critical care medicine, coronary artery disease, interventional cardiology, arrythmia and electrophysiology, atherosclerosis, hypertension, cardiomyopathy and heart failure, valvular and structure cardiac disease, pediatric cardiology, cardiovascular surgery, and so on. We received papers from more than 20 countries and areas of the world. Currently, 40% of the papers were submitted to Acta Cardiologica Sinica from Taiwan, 20% from China, and 20% from the other countries and areas in the world. The acceptance rate for publication was around 50% in general.
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