Telehealth intervention programs for seniors: An observational study of a community-embedded health monitoring initiative

Journal article


Hamilton, Taya, Johnson, Liam, Quinn, Brian T., Coppola, Jean, Sachs, David, Migliaccio, John, Phipps, Colette, Schwartz, Jennifer, Capasso, Marikay, Carpenter, Mae and Putrino, David. (2020). Telehealth intervention programs for seniors: An observational study of a community-embedded health monitoring initiative. Telemedicine and e-health. 26(4), pp. 438-445. https://doi.org/10.1089/tmj.2018.0248
AuthorsHamilton, Taya, Johnson, Liam, Quinn, Brian T., Coppola, Jean, Sachs, David, Migliaccio, John, Phipps, Colette, Schwartz, Jennifer, Capasso, Marikay, Carpenter, Mae and Putrino, David
Abstract

Background:Chronic disease in older adults is estimated to account for 84% of annual health care spending in the United States, with many preventable costs expected to rise as the population continues to age.

Introduction:Telehealth Intervention Programs for Seniors (TIPS) is a community-embedded program targeting low-income older adults, providing weekly assessment of vital signs and subjective wellness, and wrap-around aging services.

Materials and Methods:TIPS recruited 765 volunteers over 55 years, who were Medicaid and/or Medicare eligible. Data were collected from 2014 to 2016 [median enrollment 343 days (105–435)] using 12 TIPS sites. This observational study evaluated the efficacy of TIPS by measuring within-subject changes in self-reported hospital visits and <30-day readmissions, before and during TIPS participation. Data of 617 participants (median age 74.3; interquartile range 16) were analyzed.

Results:Self-reported hospital visits were reduced by 28.9% (p = 0.0013). Medicare participants benefited the most, with a 50% (p < 0.0001) reduction in hospital visits, and a 75.5% (p = 0.017) reduction in <30-day readmissions. Multivariate analysis revealed that participants (1) Medicaid-registered (odds ratio [OR] = 2.72, 95% confidence interval [CI] 0.392–1.611), (2) reporting feeling unwell (OR = 1.33, 95% CI 0.118–0.459), and (3) living alone (OR = 2.34, 95% CI 0.115–1.592) were significantly more likely than other participants to experience a hospital visit.

Discussion:TIPS demonstrates that community-embedded health services can reduce rates of hospital visits in older adults.

Conclusion:The success of TIPS highlights the potential of successfully deployed remote patient-monitoring initiatives in reducing the utilization of costly health services.

Keywordstelehealth; older adults; chronic disease; remote patient monitoring
Year2020
JournalTelemedicine and e-health
Journal citation26 (4), pp. 438-445
PublisherMary Ann Liebert, Inc. Publishers
ISSN1530-5627
Digital Object Identifier (DOI)https://doi.org/10.1089/tmj.2018.0248
Scopus EID2-s2.0-85077557702
Research or scholarlyResearch
Page range438-445
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online17 Apr 2019
Publication process dates
Accepted01 Mar 2019
Deposited12 Jul 2021
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