Can telehealth reduce health care expenditure? A lesson from German health insurance data.
Germany
chronic heart failure
health economic evaluation
managed care
telemedical program
Journal
The International journal of health planning and management
ISSN: 1099-1751
Titre abrégé: Int J Health Plann Manage
Pays: England
ID NLM: 8605825
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
15
01
2019
revised:
04
02
2019
accepted:
05
02
2019
pubmed:
30
3
2019
medline:
29
5
2020
entrez:
30
3
2019
Statut:
ppublish
Résumé
This study analyzes a telemedical program for chronic heart failure in Germany with respect to economic and treatment indicators. The program entails a routine data-based preselection of the insured and specific treatment intensities for low- and high-risk patients. This study complements previous research by considering differentiated end points such as mortality and rehospitalization as well as ambulatory, outpatient, and medication costs to account for potential cost shifts. In addition, different time frames and regional characteristics are dealt with. A difference-in-differences approach accounts for potential self-selection into the voluntary program. Our results challenge the current paradigm of program-induced cost shifting between hospital and ambulatory care. Except for a short-term effect in the lower-risk group, the program is associated with raising hospital admission rates as well as higher costs in all categories, while mortality is significantly reduced. The findings are robust as to various sensitivity checks.
Types de publication
Journal Article
Langues
eng
Pagination
1121-1132Informations de copyright
© 2019 John Wiley & Sons, Ltd.
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