Cost-effectiveness of telehealth with remote patient monitoring for postpartum hypertension

Abstract

Objective

Evaluate cost-effectiveness of telehealth with remote monitoring for postpartum hypertensive disorders from the hospital’s perspective.

Methods

A decision tree was developed using results from a non-randomized controlled trial comparing telehealth to standard outpatient blood pressure monitoring. At discharge, postpartum women with a hypertensive disorder received a Bluetooth tablet, blood pressure monitor, and scale to submit vitals daily for 6 weeks. Women were managed and treated with a standard protocol. We performed a cost-effectiveness analysis using data from the hospital, device manufacturer supplied charges, and utilities. A cost-effectiveness threshold was set at $100,000/quality-adjusted life years. One-way and two-way sensitivity analyses were performed to evaluate the robustness of our results compared to baseline assumptions.

Results

Telehealth monitoring significantly reduced postpartum readmissions, 3.7% (8/214) versus 0.5% (1/214), and resulted in higher quality-adjusted life years. Telehealth monitoring was cost-effective and cost-saving. Average cost of telehealth per patient was $309, and was cost-effective to a cost of $420 per patient. Telehealth monitoring remained cost-effective down to an admission cost of $10,999 compared to our baseline-estimate for the average admission cost of $14,401. Telehealth monitoring also remained cost-effective when the postpartum readmission rate was 3.0% or higher with standard monitoring. With a cost saving of $93 per patient and an estimated 333,253 pregnant women with hypertension in the US a year, telehealth could reduce health care costs in the US by approximately $31 million a year.

Conclusions

This study demonstrates telehealth with remote blood pressure monitoring may be a cost-effective and cost-saving solution for management of postpartum hypertension.

Keywords:

• Cost-effectiveness
• cost-saving
• telehealth
• postpartum hypertension
• remote blood pressure monitoring

Acknowledgements

This study was conceived, developed, and executed by the authors with no external or commercial support.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This project was funded by the UnityPoint Health-Meriter Foundation and the University of Wisconsin Department of Obstetrics & Gynecology intramural departmental funding.