<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Introduction</h3>
<p>Telemonitoring improves clinical outcomes in patients with arterial hypertension (AH) and type 2 diabetes (T2D), however, cost structure analyses are lacking. This study seeks to explore the cost structure of telemonitoring for the elderly with AH and T2D in primary care and identify factors influencing costs for potential future expansions.</p>
</sec>
<sec>
<h3>Methods</h3>
<p>Infrastructure, operational, patient participation, and out-of-pocket costs were determined using a bottom-up approach. Infrastructure costs were determined by dividing equipment and telemonitoring platform expenses by the number of participants. Operational and patient participation costs were determined by considering patient training time, data measurement/review time, and teleconsultation time. The change in out-of-pocket costs was assessed in both groups using a structured questionnaire and 12-month expenditure data. Statistical analysis employed an unpaired sample t-test, Mann-Whitney U test, and chi-square test.</p>
</sec>
<sec>
<h3>Results</h3>
<p>A total of 117 patients aged 71.4±4.7 years were included in the study. The telemonitoring intervention incurred an annual infrastructure costs of €489.4 and operational costs of €97.3 (95% CI 85.7-109.0) per patient. Patient annual participation costs were €215.6 (95% CI 190.9-241.1). Average annual out-of-pocket costs for both groups were €345 (95% CI 221-469). After 12 months the telemonitoring group reported significantly lower out-of-pocket costs (€132 vs. €545, p&lt;0.001), driven by reduced spending on food, dietary supplements, medical equipment, and specialist check-ups compared to the standard care group.</p>
</sec>
<sec>
<h3>Conclusion</h3>
<p>To optimise the cost structure of telemonitoring, strategies like shortening the telemonitoring period, developing a national telemonitoring platform, using patient devices, integrating artificial intelligence into platforms, and involving nurse practitioners as telemedicine centre coordinators should be explored.</p>
</sec>
</abstract>

Introduction
Telemonitoring improves clinical outcomes in patients with arterial hypertension (AH) and type 2 diabetes (T2D), however, cost structure analyses are lacking. This study seeks to explore the cost structure of telemonitoring for the elderly with AH and T2D in primary care and identify factors influencing costs for potential future expansions.


Methods
Infrastructure, operational, patient participation, and out-of-pocket costs were determined using a bottom-up approach. Infrastructure costs were determined by dividing equipment and telemonitoring platform expenses by the number of participants. Operational and patient participation costs were determined by considering patient training time, data measurement/review time, and teleconsultation time. The change in out-of-pocket costs was assessed in both groups using a structured questionnaire and 12-month expenditure data. Statistical analysis employed an unpaired sample t-test, Mann-Whitney U test, and chi-square test.


Results
A total of 117 patients aged 71.4±4.7 years were included in the study. The telemonitoring intervention incurred an annual infrastructure costs of €489.4 and operational costs of €97.3 (95% CI 85.7-109.0) per patient. Patient annual participation costs were €215.6 (95% CI 190.9-241.1). Average annual out-of-pocket costs for both groups were €345 (95% CI 221-469). After 12 months the telemonitoring group reported significantly lower out-of-pocket costs (€132 vs. €545, p<0.001), driven by reduced spending on food, dietary supplements, medical equipment, and specialist check-ups compared to the standard care group.


Conclusion
To optimise the cost structure of telemonitoring, strategies like shortening the telemonitoring period, developing a national telemonitoring platform, using patient devices, integrating artificial intelligence into platforms, and involving nurse practitioners as telemedicine centre coordinators should be explored.

Bottom-Up Analysis of Telemonitoring Costs: A Case Study in Slovenian Primary Care

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

ANALIZA STROŠKOV TELEMONITORINGA OD SPODAJ NAVZGOR: ŠTUDIJA PRIMERA V SLOVENSKEM PRIMARNEM ZDRAVSTVU

Introduction
Telemonitoring improves clinical outcomes in patients with arterial hypertension (AH) and type 2 diabetes (T2D), however, cost structure analyses...

Bottom-Up Analysis of Telemonitoring Costs: A Case Study in Slovenian Primary Care

Article Category: Original scientific article

Published Online: Jan 03, 2024

Page range: 5 - 13

Received: Sep 15, 2023

Accepted: Nov 23, 2023

DOI: https://doi.org/10.2478/sjph-2024-0002

Keywords
Costs, Telemonitoring, Primary care, Elderly, Diabetes, Hypertension

© 2024 Matic MIHEVC et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Bottom-Up Analysis of Telemonitoring Costs: A Case Study in Slovenian Primary Care

Article Category: Original scientific article

Published Online: Jan 03, 2024

Page range: 5 - 13

Received: Sep 15, 2023

Accepted: Nov 23, 2023

DOI: https://doi.org/10.2478/sjph-2024-0002

KeywordsCosts, Telemonitoring, Primary care, Elderly, Diabetes, Hypertension

© 2024 Matic MIHEVC et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Costs, Telemonitoring, Primary care, Elderly, Diabetes, Hypertension