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Table 5 Impact of telesurveillance on home care interventions and hospitalizations

From: Public telesurveillance service for frail elderly living at home, outcomes and cost evolution: a quasi experimental design with two follow-ups

Measures (n = 38)

before TU1

after TU

before TU

after TU

 

0–3 months

0–3 months

4–6 months

-3-0 months

-3-0 months

4–6 months

Category of home care worker from the primary care center

Number of home visits

Cost of home visits 2 (CAN$)

   - Social worker

126

85

62

7207.20

4862.00

3546.40

   - Home help

316

280

186

14166.28

12552.40

8338.38

   - Occupational/Physiotherapist (106.20$/visit)

79

48

13

8389.80

5097.60

1380.60

   - Nurse (60.23$/h)

179

134

130

10781.17

8070.82

7829.90

   - Psychologist (200.62$/interview)

8

1

2

1604.96

200.62

401.24

   - Dietitian (57.76$/h)

10

19

0

577.60

1097.44

0.00

   - Medical services

8

4

7

412.35

220.10

343.40

   - Laboratory tests/services

0

3

5

0.00

17.13

28.55

TOTAL

726

574

405

43139.36

32118.11

21868.47

Average/client

18.4 ± 27.0

15.3 ± 20.1

10.4 ± 16.6*

1135.25

845.21

575.49

Hospitalisations

Average cost of hospitalizations (CAN$) 3

   - Admissions

12

10

10

   

   - Average length of stay (ALS, days)

13

9.5 (-27%)

4 (-58%)

   

   - Total duration of hospitalizations4 (TDH, days)

155

94 (-39%)

39 (-75%)

62246.75

40781.90

16920.15

   - Nb of hospitalized clients

11

6 (-45%)

7 (-36%)

   

Average cost/client (n = 38)

1638.07

1073.21

445.27

Cost of operating the telesurveillance center

   

   - Cost of the platform (amortized over 5 years)

0.00

1644.75

1644.75

   - Maintenance contract

0.00

750.00

750.00

   - Equipment purchase cost (estimated at 300 devices/year; 700$/device)

0.00

52500.00

52500.00

   - Nurses' salaries5 (for the territory: 5.2 nurses/1200 clients; 24 × 7)

0.00

381953.50

381953.50

   - Installation and repair costs (including technician's salary)

0.00

12500.00

12500.00

   - Administration

0.00

9000.00

9000.00

Subtotal

 

458348.25

458348.25

Cost/client (n = 1200)

 

381.96

381.96

TOTAL

2773.32

2300.38

1402.72

Fee paid by the client (25$/month)

 

75.00

75.00

  1. 1TU: Telesurveillance use.
  2. *Significant difference after 6 months, p = 0.004.
  3. 2See refs [29,30,31] for health professionals' salary and laboratory services cost.
  4. 3This result is calculated according to the average length of stay × number of clients hospitalized × 433.85$/day, see ref [30]. If the duration of all hospitalizations is known, the TDH is used directly to calculate the average cost of hospitalizations.
  5. 4For example, for the period 0–3 months before installation: the TDH is calculated by replacing unknown values with the known ALS (obtained from known values).
  6. # of hospitalizations of unknown duration = 8; # of hospitalizations of known duration = 4, totalling 51 days;
  7. Average length of stay (ALS) = 51 days/4 = 12.75 days, approx. 13 days;
  8. TDH = known number of days + 8 (ALS) = 51 days + 8(13) = 155 days.
  9. 5salary: 33.54$/h, including benefits and payroll taxes. See ref [30].