@Article{info:doi/10.2196/jmir.9552,
author="Lanssens, Dorien
and Vandenberk, Thijs
and Smeets, Christophe JP
and De Canni{\`e}re, H{\'e}l{\`e}ne
and Vonck, Sharona
and Claessens, Jade
and Heyrman, Yenthel
and Vandijck, Dominique
and Storms, Valerie
and Thijs, Inge M
and Grieten, Lars
and Gyselaers, Wilfried",
title="Prenatal Remote Monitoring of Women With Gestational Hypertensive Diseases: Cost Analysis",
journal="J Med Internet Res",
year="2018",
month="Mar",
day="26",
volume="20",
number="3",
pages="e102",
keywords="remote monitoring; gestational hypertensive diseases; reimbursement; cost-effectiveness",
abstract="Background: Remote monitoring in obstetrics is relatively new; some studies have shown its effectiveness for both mother and child. However, few studies have evaluated the economic impact compared to conventional care, and no cost analysis of a remote monitoring prenatal follow-up program for women diagnosed with gestational hypertensive diseases (GHD) has been published. Objective: The aim of this study was to assess the costs of remote monitoring versus conventional care relative to reported benefits. Methods: Patient data from the Pregnancy Remote Monitoring (PREMOM) study were used. Health care costs were calculated from patient-specific hospital bills of Ziekenhuis Oost-Limburg (Genk, Belgium) in 2015. Cost comparison was made from three perspectives: the Belgian national health care system (HCS), the National Institution for Insurance of Disease and Disability (RIZIV), and costs for individual patients. The calculations were made for four major domains: prenatal follow-up, prenatal admission to the hospital, maternal and neonatal care at and after delivery, and total amount of costs. A simulation exercise was made in which it was calculated how much could be demanded of RIZIV for funding the remote monitoring service. Results: A total of 140 pregnancies were included, of which 43 received remote monitoring (30.7{\%}) and 97 received conventional care (69.2{\%}). From the three perspectives, there were no differences in costs for prenatal follow-up. Compared to conventional care, remote monitoring patients had 34.51{\%} less HCS and 41.72{\%} less RIZIV costs for laboratory test results (HCS: mean {\texteuro}0.00 [SD {\texteuro}55.34] vs mean {\texteuro}38.28 [SD {\texteuro} 44.08], P<.001; RIZIV: mean {\texteuro}21.09 [SD {\texteuro}27.94] vs mean {\texteuro}36.19 [SD {\texteuro}41.36], P<.001) and a reduction of 47.16{\%} in HCS and 48.19{\%} in RIZIV costs for neonatal care (HCS: mean {\texteuro}989.66 [SD {\texteuro}3020.22] vs mean {\texteuro}1872.92 [SD {\texteuro}5058.31], P<.001; RIZIV: mean {\texteuro}872.97 [SD {\texteuro}2761.64] vs mean {\texteuro}1684.86 [SD {\texteuro}4702.20], P<.001). HCS costs for medication were 1.92{\%} lower in remote monitoring than conventional care (mean {\texteuro}209.22 [SD {\texteuro}213.32] vs mean {\texteuro}231.32 [SD 67.09], P=.02), but were 0.69{\%} higher for RIZIV (mean {\texteuro}122.60 [SD {\texteuro}92.02] vs mean {\texteuro}121.78 [SD {\texteuro}20.77], P<.001). Overall HCS costs for remote monitoring were mean {\texteuro}4233.31 (SD {\texteuro}3463.31) per person and mean {\texteuro}4973.69 (SD {\texteuro}5219.00) per person for conventional care (P=.82), a reduction of {\texteuro}740.38 (14.89{\%}) per person, with savings mainly for RIZIV of {\texteuro}848.97 per person (23.18{\%}; mean {\texteuro}2797.42 [SD {\texteuro}2905.18] vs mean {\texteuro}3646.39 [SD {\texteuro}4878.47], P=.19). When an additional fee of {\texteuro}525.07 per month per pregnant woman for funding remote monitoring costs is demanded, remote monitoring is acceptable in their costs for HCS, RIZIV, and individual patients. Conclusions: In the current organization of Belgian health care, a remote monitoring prenatal follow-up of women with GHD is cost saving for the global health care system, mainly via savings for the insurance institution RIZIV. ",
issn="1438-8871",
doi="10.2196/jmir.9552",
url="http://www.jmir.org/2018/3/e102/",
url="https://doi.org/10.2196/jmir.9552",
url="http://www.ncbi.nlm.nih.gov/pubmed/29581094"
}