Telehealth and hospitalizations for medicare home healthcare patients

Objective: To examine the effect of an integrated, clinician-focused telehealth monitoring system on the probability of hospitalization within the first 30-day episode of home healthcare. Study Design: Retrospective, nonexperimental design. Methods: The study sample includes 2009 data from 5873 Medicare beneficiaries receiving home healthcare services through a network of community-based home health agencies operating in Texas and Louisiana. Propensity-score matching was used to control for selection bias. Logistic regression and postestimation parameter simulation were used to assess how the use of an integrated, clinician-focused telehealth monitoring system might affect the probability of hospitalization during the first 30-day episode of home healthcare. Results: The 30-day probability of hospitalization for telehealth and non-telehealth patients was 10.3% and 17.1%, respectively. Patients in the telehealth group had a 7-percentage-point (95% confidence interval 4.2, 9.4) lower probability of hospitalization within the first 30-day episode of home healthcare than those in the non-telehealth group. Conclusion: The use of an integrated, clinician-focused telehealth monitoring system can substantially reduce the 30-day probability of hospitalization for home healthcare patients. Telehealth monitoring systems that integrate skilled clinicians can lead to substantial hospitalization-related cost savings.