Economic assessment of ulcer tele-monitoring

The study was to generate information for the decision-making process regarding the national introduction of tele-monitoring of patients with diabetic foot ulcers.

AIM

From a healthcare sector perspective, a cost-effectiveness analysis was performed comparing the costs and effects of telemonitoring with standard monitoring for patients with diabetic foot ulcers. The telemonitoring included two teleconsultations in the patient’s own home and one consultation in the clinic, while standard monitoring included three clinical consultations. Resource consumption, costs, and effects of both groups were measured and calculated over a six-month period. The primary clinical outcome was avoiding amputations. Data came from questionnaires and interviews from the randomised controlled study and from national health administrative databases.

RESULTS

The cost-effectiveness analysis was performed on data from 374 patients randomised to either telemonitoring (193 patients) or standard monitoring (181 patients). The cost for a telemonitored patient is approx. DKK 15,000 less compared to a standard-monitored patient, although the observed difference is not statistically significant. The difference is mainly due to lower costs for hospitalisations and other clinical visits. On average, fewer amputations occur in the telemonitored group (11%) compared to the standard-monitored group (14%).

By combining this information, the extra cost per extra amputation shows a saving of approx. DKK 510,000 to avoid an amputation, although none of the differences are statistically significant.

EXTERNAL FUNDING

The project was part of the EU project Renewing Health.