A Prenatal Remote Monitoring Program in Pregnancies Complicated with Gestational Hypertensive Disorders: What Are the Contributors to the Cost Savings?

Telemed J E Health. 2019 Aug;25(8):686-692. doi: 10.1089/tmj.2018.0147. Epub 2018 Oct 30.

Abstract

Background:In 2015, we performed a cost analysis of a prenatal remote monitoring (RM) program compared with conventional care (CC) for women diagnosed with gestational hypertensive disorders (GHD).Introduction:We investigated where the cost savings were distributed by dividing our patient population into three subgroups, according to the gestational age (GA) at the time of delivery: (1) <34 weeks; (2) 34-37 weeks; and (3) >37 weeks of GA.Materials and Methods:Health care costs were calculated from patient-specific hospital bills at Ziekenhuis Oost Limburg (Genk, Belgium) in 2015-2016. Cost comparisons were made from the perspectives of the Belgium national health care system (HCS), the National Institution for Insurance of Disease and Disability (RIZIV), and the costs to individual patients.Results:A total of 256 pregnant women were included, 80 (31.25%) of whom received RM and 176 (68.75%) of whom received CC. The greatest difference in costs between RM and CC was in the group that delivered before 34 weeks of GA, followed by the group who delivered after 37 weeks of GA, and then the group of women who delivered at 34-37 weeks of GA. Most of the cost savings were in neonatal care, for both the three separate study subgroups and the total study group.Discussion and Conclusion:Our data showed that RM is more cost-effective than CC for pregnant women with GHD. Further investigation of the effects of RM on the long-term economic and social costs is recommended, together with an analysis of the price that should be asked for RM services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accelerometry
  • Adult
  • Animals
  • Belgium
  • Blood Pressure Monitoring, Ambulatory
  • Body Weight
  • Cost Savings
  • Cost-Benefit Analysis
  • Female
  • Gestational Age
  • Health Expenditures
  • Humans
  • Hypertension, Pregnancy-Induced / therapy*
  • Models, Econometric
  • Monitoring, Ambulatory / methods*
  • Pregnancy
  • Retrospective Studies
  • State Medicine / organization & administration
  • Telemedicine / economics
  • Telemedicine / organization & administration*
  • Young Adult