Presentation Abstract

Session: AOS.506.03-Monitoring Heart Failure Patients and Outcomes
Presentation: 14767 - Integrated Telehealth and Care Management Program Reduces All Cause Mortality in Medicare Beneficiaries with Heart Failure
Pres Time: Wednesday, Nov 07, 2012, 10:45 AM -11:00 AM
Location: Room 408b
Pres. Time: Wednesday, Nov 07, 2012, 10:45 AM -11:00 AM
Specialty: +506. Heart Failure: Disease Management, Quality of Care, and Clinical Outcomes
Keywords: Heart failure; Disease management; Telemedicine; Healthcare innovation
Authors: Robert L Page II, Univ Colorado Sch Pharmacy, Aurora, CO; David P Kao, Univ of Colorado Sch of Med, Aurora, CO; Dendy Macaulay, Analysis Group, New York, NY; Howard G Birnbaum, John Jarvis, Urvi Desai, Analysis Group, Boston, MA; JoAnn Lindenfeld, Univ Colorado Sch Pharmacy, Aurora, CO
Abstract: Background: Fragmented delivery systems and lack of continuity of care are potential barriers to the effective treatment of patients with heart failure (HF). Benefits of telehealth technology on mortality in HF are unknown.
Hypothesis: The Health Buddy Program (HBP), a telehealth monitoring and care management tool that allows providers to risk-stratify patients and improves communication of symptoms, vital signs, and health behaviors, may help reduce mortality.
Methods: Retrospective Medicare claims data for HF beneficiaries enrolled in a 2006-2010 Medicare HBP demonstration project (intervention group) were compared to control HF Medicare beneficiaries. The intervention group was further stratified as engaged (used HBP >1 time) and nonengaged (never used HBP). HF was identified by ICD-9 codes, and intervention and control beneficiaries were propensity-score matched using logistic regression, controlling for demographics, select comorbidities, the Elixhauser comorbidity index, total health care costs, and select all-cause and HF resource utilization during the baseline year. HBP’s effect on all-cause mortality over three years was estimated using Kaplan-Meier survival analysis and Cox proportional hazards models for: intervention vs. matched controls, engaged vs. matched controls, and non-engaged vs. matched controls. Cox models controlled for baseline differences in age, comorbidities, number of provider visits, and year of enrollment.
Results: Data for 623 matched pairs of Medicare HF beneficiaries were analyzed. The intervention was associated with a significant reduction in all-cause mortality in Medicare beneficiaries with HF (Figure). Results were robust in the engaged subgroup (37% of the intervention group) compared to matched controls.
Conclusion: Use of the HBP is associated with a significant reduction in all-cause mortality in Medicare beneficiaries with HF.
Disclosures:  R.L. Page, None; D.P. Kao, Bosch Healthcare, Modest,Consultant/Advisory Board; D. Macaulay, None; H.G. Birnbaum, None; J. Jarvis, None; U. Desai, None; J. Lindenfeld, None.



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