TY - JOUR
T1 - SAFE@HOME
T2 - Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia
AU - van den Heuvel, Josephus F.M.
AU - van Lieshout, Christiaan
AU - Franx, Arie
AU - Frederix, Geert
AU - Bekker, Mireille N.
N1 - Funding Information:
None. JFH, CL, GF and MNB designed the study. JFH and MNB were responsible for the acquisition and interpretation of the data. JFH, CL, AF and MNB drafted the manuscript. All authors edited and revised the manuscript. All authors have read and approved the final version of the manuscript. This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). This study was submitted to the Medical Ethics Committee of the University Medical Center in Utrecht (17/424). The committee judged that the Dutch Medical Research Involving Human Subjects Act (WMO) did not apply to this study.
Funding Information:
This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU).
Publisher Copyright:
© 2021 The Authors
Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - OBJECTIVE: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia.STUDY DESIGN: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring.MAIN OUTCOME MEASURES: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence.RESULTS: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 - 5329] vs €4504 [IQR 3515-6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338-10,173] vs €9150, [IQR 7546-12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources.CONCLUSION: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.
AB - OBJECTIVE: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia.STUDY DESIGN: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring.MAIN OUTCOME MEASURES: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence.RESULTS: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 - 5329] vs €4504 [IQR 3515-6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338-10,173] vs €9150, [IQR 7546-12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources.CONCLUSION: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.
KW - Adult
KW - Blood Pressure Determination
KW - Blood Pressure Monitoring, Ambulatory/economics
KW - Blood Pressure/physiology
KW - Case-Control Studies
KW - Costs and Cost Analysis
KW - Female
KW - Health Care Costs
KW - Humans
KW - Hypertension/epidemiology
KW - Patient Satisfaction
KW - Pre-Eclampsia/diagnosis
KW - Pregnancy
KW - Pregnancy Complications/epidemiology
KW - Prenatal Care/economics
KW - Telemedicine/economics
UR - http://www.scopus.com/inward/record.url?scp=85103653462&partnerID=8YFLogxK
U2 - 10.1016/j.preghy.2021.03.004
DO - 10.1016/j.preghy.2021.03.004
M3 - Article
C2 - 33813364
AN - SCOPUS:85103653462
SN - 2210-7789
VL - 24
SP - 118
EP - 123
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
ER -