141st APHA Annual Meeting

In This section

292920
Using tele-health to affect cardiovascular outcomes in rural areas: The case of southern appalachia - final results

Monday, November 4, 2013 : 3:06 PM - 3:18 PM

Brian C. Martin, PhD, MBA , Department of Health Services Management and Policy, East Tennessee State University, College of Public Health, Johnson City, TN
Amal Khoury, PhD, MPH , College of Public Health, East Tennessee State University, Johnson City, TN
Xuefeng Liu, PhD , Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN
Selina Clark, MPH , Department of Health Services Management and Policy, East Tennessee College of Public Health, Johnson City, TN
Cara Wicks, BS , Department of Health Services Management and Policy, East Tennessee College of Public Health, Johnson City, TN
The Southern Appalachia Tele-Homecare program seeks to improve CHF outcomes while reducing hospitalization and costs in a rural, medically underserved area. SATH integrates patient participation and progressive self-care, tele-monitoring, home healthcare, call center monitoring, and standing physician orders in a multidisciplinary team. SATH employs a randomized control study design and a multi-pronged evaluation to assess quality of care, utilization outcomes, and cost-effectiveness. Results (to be updated for presentation): ENROLLMENT: As of 8/31/12, 289 patients were enrolled; 178 in the treatment and 111 in the control group. Of the 190 patients currently eligible for the satisfaction survey, 172 completed (92% response). Intervention patients were significantly more satisfied with their home health than control patients. For the 6-month quality-of-life assessment, 156 of 180 eligible patients responded. The 12-month assessment was completed by 98 of 131 eligible patients. The average QoL score was 51.9 at 6-months and 49.7 at 12 months (maximum 105), with no significant differences between the two groups. FINANCIAL: While initial costs of care are higher in the treatment group relative to the control group ($3,821 vs. $1,087 per patient), the net savings, due to avoided home health visits and mileage costs, realized in the treatment group was 62% of the cost of care in the control group. CONCLUSION: Tele-homecare can be successfully implemented in rural communities, and adapted to other chronic conditions and geographic locations. ALL FINDINGS WILL BE UPDATED THROUGH THE END OF THE PROJECT PERIOD (MARCH 31, 2013) FOR PRESENTATION.

Learning Areas:
Administration, management, leadership
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public

Learning Objectives:
Discuss progress for an innovative model using tele-health for CHF management in rural areas. Define the components of a comprehensive evaluation framework for disease management programs. Evaluate th eimpact of a tele-health CHF program on the quality and cost of care. Demonstrate a tele-health CHF disease management approach that can be applied to other conditions and geographic settings.

Keywords: Telehealth, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Co-I on this grant, have 15 years of practice experience and 13 years of academic experience in the field of health services administration.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3316.0: Rural Aging Issues