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Impact of a High-Risk, Ambulatory COVID-19 Remote Patient Monitoring Program on Utilization, Cost, and Mortality

Published:September 05, 2022DOI:https://doi.org/10.1016/j.mayocp.2022.08.015
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      Abstract

      Objective

      To evaluate care utilization, cost, and mortality among high-risk patients enrolled in a COVID-19 Remote Patient Monitoring (RPM) program.

      Methods

      This retrospective analysis included patients diagnosed with COVID-19 at risk for severe disease who enrolled in the RPM program between March 2020 - October 2021. The program included in-home technology for symptom and physiologic data monitoring with centralized care management. Propensity score matching established matched cohorts of RPM-engaged (defined as ≥1 RPM technology interactions) and non-engaged patients using a logistic regression model of 59 baseline characteristics. Billing codes and the electronic death certificate system were utilized for data abstraction from the EHR and reporting of care utilization and mortality endpoints.

      Results

      Among 5,796 RPM-enrolled patients, 80.0% engaged with the technology. Following matching, 1,128 pairs of RPM engaged and non-engaged patients comprised the analysis cohorts. Mean patient age was 63.3 years, 50.9% of patients were female sex, and 81.9% were non-Hispanic, white. RPM-engaged patients experienced significantly lower rates of 30-day, all-cause hospitalization (13.7% vs 18.0%, P=.01), prolonged hospitalization (3.5% vs 6.7%, P=.001), ICU admission (2.3% vs. 4.2%, P=.01), and mortality [0.5% vs. 1.7%, OR 0.31 (0.12, 0.78), P=.01], as well as cost of care ($2,306.33 USD vs $3,565.97 USD, P=0.04), than those enrolled in RPM but non-engaged.

      Conclusions

      High-risk, COVID-19 patients enrolled and engaged in an RPM program experienced lower rates of hospitalization, ICU admission, mortality, and cost than those enrolled and non-engaged. These findings translate to improved hospital bed access and patient outcomes.

      Abbreviations:

      COVID-19 (Coronavirus Disease 2019), RPM (Remote Patient Monitoring), ED (Emergency Department), ICU (Intensive Care Unit), EHR (Electronic health record), SMD (Standardized mean differences), USD (U.S. Dollars)