Recently data from the Italian ARNO observatory estimated that patients hospitalized for HF in Italy have 56% risk to experience a new hospital admission within one year since their discharge ( 6) interestingly, almost half of these new hospital admissions (49%) are due to non-cardiovascular reasons, meaning that patients with cardiovascular disease require a comprehensive, multidisciplinary monitoring. Heart failure (HF) is the largest cause of hospitalization in patients aged ≥65 years in Western countries ( 3– 5). Therefore, it is of paramount importance to explore innovative solutions that hold the promise of improving clinical outcomes in the domain of cardiovascular diseases and may reduce the financial burden on healthcare systems. Over a period of 20 years (2010–2030) a +25% increase of prevalence is expected to generate an increase of +215% of costs ( 2). Unavoidably, this will be associated with an increase of direct and indirect cost. Management of acute cardiovascular diseases is constantly improving, which leads to a progressive increase of life expectancy and consequently, to a progressive increase of disease prevalence ( 1). RM adoption generated savings of −€4,771 and −€6,752 per patient in 2 years, in the payer and hospital perspective, respectively.Ĭonclusion: RM of patients carrying CIED improves short-term (2-years) morbidity and mortality risks, compared to SM and reduces direct management costs for both hospitals and healthcare services. The investment required to fund RM (a fee for service in the payer perspective, and staffing costs for hospitals), was more than offset by the lower rate of hospitalizations for CV-related disease. Overall, the implementation of the RM program in the Trento territory was cost-saving in both payer and hospital perspectives. Also, a lower proportion of patients in the RM group (25.1%) were hospitalized for CV-related reasons, compared to the SM group (51.3% p < 0.0001, two-sample test for proportions). After 2-years follow-up since CIED implantation, mortality rate for any cause was 1.6% in the RM group and 19.9% in the SM group (log-rank test, p < 0.0001). After PSM, comparison was limited to N = 191 patients in each arm. Results: In the enrollment period, N = 402 CIED patients met the inclusion criteria and were included in the analysis ( N = 189 patients followed through SM N = 213 patients followed through RM). Propensity score matching (PSM) was used to reduce the effect of confounding biases and the unbalance of patient characteristics at baseline. From an economic standpoint, direct costs of RM and SM were collected to compare the cost per treated patient over a 2-year time horizon. From a clinical standpoint, survival analysis was conducted, and incidence of cardiovascular (CV) related hospitalizations was measured. Methods: Clinical and resource consumption data were extracted from the Electrophysiology Registry of the Trento Cardiology Unit, which has been systemically collecting patient information from January 2011 to February 2022. standard monitoring (SM) through in-office cardiology visits, in patients carrying a cardiac implantable electronic device (CIED). The aim of this retrospective study was to assess the clinical and economic consequences of RM vs. Introduction: Remote monitoring (RM) technologies have the potential to improve patient care by increasing compliance, providing early indications of heart failure (HF), and potentially allowing for therapy optimization to prevent HF admissions. 4Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.3Department of Management and Economy, University of Trento, Trento, Italy.2Controlling Department, APSS (Azienda Provinciale per i Servizi Sanitari), Trento, Italy.Massimiliano Marini 1*, Lodovica Videsott 1, Chiara Francesca Dalle Fratte 2, Andrea Francesconi 3, Eleonora Bonvicini 1, Silvia Quintarelli 1, Marta Martin 1, Fabrizio Guarracini 1, Alessio Coser 1, Pier Paolo Benetollo 2, Roberto Bonmassari 1 and Giuseppe Boriani 4
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