Can telehealth reduce health care expenditure? A lesson from German health insurance data
| Autor: | Dirk Oberschachtsiek, Andree Ehlert |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Cost-shifting Telehealth German 03 medical and health sciences Ambulatory care Cost Savings Germany Health care medicine Health insurance Humans Aged Heart Failure Insurance Health business.industry 030503 health policy & services Health Policy medicine.disease Telemedicine language.human_language Ambulatory language Managed care Female Medical emergency Health Expenditures 0305 other medical science business |
| Zdroj: | The International Journal of Health Planning and Management. 34:1121-1132 |
| ISSN: | 1099-1751 0749-6753 |
| DOI: | 10.1002/hpm.2764 |
| Popis: | This study analyzes a telemedical program for chronic heart failure in Germany with respect to economic and treatment indicators. The program entails a routine data-based preselection of the insured and specific treatment intensities for low- and high-risk patients. This study complements previous research by considering differentiated end points such as mortality and rehospitalization as well as ambulatory, outpatient, and medication costs to account for potential cost shifts. In addition, different time frames and regional characteristics are dealt with. A difference-in-differences approach accounts for potential self-selection into the voluntary program. Our results challenge the current paradigm of program-induced cost shifting between hospital and ambulatory care. Except for a short-term effect in the lower-risk group, the program is associated with raising hospital admission rates as well as higher costs in all categories, while mortality is significantly reduced. The findings are robust as to various sensitivity checks. |
| Databáze: | OpenAIRE |
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