Care Coordination/Home Telehealth Diabetes Care: Daily versus Weekly Monitoring

Chumbler NR, Neugaard BI, Kobb R, Ryan P, Qin H, Joo Y. Care Coordination/Home Telehealth Diabetes Care: Daily versus Weekly Monitoring. Paper presented at: American Telemedicine Association on Remote Monitoring and Home Telehealth Fall Forum; 2004 Sep 1; Boston, MA.

We examined the utilization of health care services and clinical outcomes in 267 veterans with diabetes enrolled in two Veterans Health Administration (VHA) care coordination/home-telehealth programs. Over the one year study period, the veterans with diabetes were either monitored weekly (n = 167) or daily (n = 100) by a nurse care coordinator. We compared the inpatient and outpatient resource use as well as clinical outcomes between the two groups. We discovered that hospital admission rates, both for all-cause and for diabetes conditions, were 51.9% (p = .003) and 58.0% (p = .002), respectively, lower in the daily monitored group than in the weekly monitored group. Hospital bed-days of care, both for all cause and for diabetes conditions, were 44.0% (p < .0001) and 39.0% (p < .0001), respectively, lower in the daily monitored group than in the weekly monitored group. The unscheduled primary care clinic visits were 48.8% lower (p = .001) in the daily monitored than in the weekly monitored group. We did not find any significant differences in the clinical outcomes between the two groups. In conclusion, we found that veterans with diabetes receiving daily monitoring had fewer hospitalizations, hospital bed-days of care, and unscheduled primary care visits than those receiving weekly monitoring.