Telemedicine Diabetes Consultations are Cost-Effective, and Effects on Essential Diabetes Treatment Parameters are Similar to Conventional Treatment: 7-Year Results from the Svendborg Telemedicine Diabetes Project
Open Access
- 1 May 2013
- journal article
- meeting report
- Published by SAGE Publications in Journal of Diabetes Science and Technology
- Vol. 7 (3), 587-595
- https://doi.org/10.1177/193229681300700302
Abstract
Background: The increasing number of patients with diabetes poses a major challenge for the health care system. One instrument to meet these challenges could be the use of telemedicine, which, at the same time, may reduce treatment costs. Since 2005, diabetes patients on the island of Aeroe have been offered expert diabetes care using teleconsultations. This article describes the impact of the telemedicine solution on essential diabetes treatment parameters, patient satisfaction, and cost-effectiveness. Methods: Telemedicine consultations were conducted with the patient and nurse specialist placed in a consultation room of Aeroe Hospital in audiovisual contact with the physician situated at the hospital on the mainland. Consultations were supported by an electronic patient record and a Web-based quality-monitoring diabetes database. Results: Inclusion criteria in this retrospective study were at least 6 months of telemedicine diabetes control with a minimum of two visits and two hemoglobin A1c (HbA1c) values. Results were compared with data from the Danish National Diabetes Registry (DVDD). Data are given in medians. In total, 23 type 1 diabetes mellitus (T1DM) patients, aged 65 (56–74) versus 48 years, diabetes duration 21.0 (10.7–31.3) versus 20.5 years, and 55 type 2 diabetes mellitus (T2DM) patients, aged 67 (64–70) versus 65 years, diabetes duration 14.0 (10.5–17.5) versus 11.7 years, were included. After teleconsultation, HbA1c in T1DM patients was 8.0% (7.4–8.6%) versus 7.9% [64 (57–71) versus 63 mmol/mol], not significant, and in T2DM patients was 7.4% (7.1–7.7%) versus 7.6% [57 (54–61) versus 60 mmol/mol], p < .05. Body mass index, blood pressure, and lipid values were comparable with the DVDD. Patient satisfaction was especially related to the major reduction in transportation time (7 h). Reductions in traveling costs and saved working days were the most important factors in making the telemedicine set-up economically efficient. Conclusion: Telemedicine consultation for remote outpatient diabetes control is feasible, and the interdisciplinary interventions achieved high treatment quality results in essential diabetes treatment parameters. In addition, the telemedicine set-up was associated with improved cost-effectiveness and patient satisfaction.Keywords
This publication has 18 references indexed in Scilit:
- Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trialBMJ, 2012
- The Diabeo Software Enabling Individualized Insulin Dose Adjustments Combined With Telemedicine Support Improves HbA1c in Poorly Controlled Type 1 Diabetic PatientsDiabetes Care, 2011
- Medicare payments, healthcare service use, and telemedicine implementation costs in a randomized trial comparing telemedicine case management with usual care in medically underserved participants with diabetes mellitus (IDEATel)Journal of the American Medical Informatics Association, 2010
- Home telehealth for diabetes management: a systematic review and meta‐analysisDiabetes, Obesity and Metabolism, 2009
- A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus: 5 Year Results of the IDEATel StudyJournal of the American Medical Informatics Association, 2009
- Can economic evaluation in telemedicine be trusted? A systematic review of the literatureCost Effectiveness and Resource Allocation, 2009
- 10-Year Follow-up of Intensive Glucose Control in Type 2 DiabetesThe New England Journal of Medicine, 2008
- Intensive Glycemic Control in the ACCORD and ADVANCE TrialsThe New England Journal of Medicine, 2008
- Systematic Review of Home Telemonitoring for Chronic Diseases: The Evidence BaseJournal of the American Medical Informatics Association, 2007
- Economic Analysis of a Telemedicine Intervention to Improve Glycemic Control in Patients with Diabetes MellitusDisease Management and Health Outcomes, 2006