Taya Hamilton1, Liam Johnson2, Brian T Quinn1, Jean Coppola3,4, David Sachs3,4, John Migliaccio3, Colette Phipps3,5, Jennifer Schwartz3,5, Marikay Capasso3,5, Mae Carpenter3,5, David Putrino1,3,6. 1. Department of Telemedicine and Virtual Rehabilitation, Burke Medical Research Institute, White Plains, New York. 2. Stroke Department, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia. 3. Westchester Public/Private Partnership for Aging Services, White Plains, New York. 4. Seidenberg School of Computer Science and Information Systems, Pace University, Pleasantville, New York. 5. Department of Senior Program and Services, The Westchester County Department of Senior Programs and Services, White Plains, New York. 6. Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, Manhattan, New York.
Abstract
Background: Chronic disease in older adults is estimated to account for 84% of annual health care spending in the United States, with many preventable costs expected to rise as the population continues to age. Introduction: Telehealth Intervention Programs for Seniors (TIPS) is a community-embedded program targeting low-income older adults, providing weekly assessment of vital signs and subjective wellness, and wrap-around aging services. Materials and Methods: TIPS recruited 765 volunteers over 55 years, who were Medicaid and/or Medicare eligible. Data were collected from 2014 to 2016 [median enrollment 343 days (105-435)] using 12 TIPS sites. This observational study evaluated the efficacy of TIPS by measuring within-subject changes in self-reported hospital visits and <30-day readmissions, before and during TIPS participation. Data of 617 participants (median age 74.3; interquartile range 16) were analyzed. Results: Self-reported hospital visits were reduced by 28.9% (p = 0.0013). Medicare participants benefited the most, with a 50% (p < 0.0001) reduction in hospital visits, and a 75.5% (p = 0.017) reduction in <30-day readmissions. Multivariate analysis revealed that participants (1) Medicaid-registered (odds ratio [OR] = 2.72, 95% confidence interval [CI] 0.392-1.611), (2) reporting feeling unwell (OR = 1.33, 95% CI 0.118-0.459), and (3) living alone (OR = 2.34, 95% CI 0.115-1.592) were significantly more likely than other participants to experience a hospital visit. Discussion: TIPS demonstrates that community-embedded health services can reduce rates of hospital visits in older adults. Conclusion: The success of TIPS highlights the potential of successfully deployed remote patient-monitoring initiatives in reducing the utilization of costly health services.
Background: Chronic disease in older adults is estimated to account for 84% of annual health care spending in the United States, with many preventable costs expected to rise as the population continues to age. Introduction: Telehealth Intervention Programs for Seniors (TIPS) is a community-embedded program targeting low-income older adults, providing weekly assessment of vital signs and subjective wellness, and wrap-around aging services. Materials and Methods: TIPS recruited 765 volunteers over 55 years, who were Medicaid and/or Medicare eligible. Data were collected from 2014 to 2016 [median enrollment 343 days (105-435)] using 12 TIPS sites. This observational study evaluated the efficacy of TIPS by measuring within-subject changes in self-reported hospital visits and <30-day readmissions, before and during TIPS participation. Data of 617 participants (median age 74.3; interquartile range 16) were analyzed. Results: Self-reported hospital visits were reduced by 28.9% (p = 0.0013). Medicare participants benefited the most, with a 50% (p < 0.0001) reduction in hospital visits, and a 75.5% (p = 0.017) reduction in <30-day readmissions. Multivariate analysis revealed that participants (1) Medicaid-registered (odds ratio [OR] = 2.72, 95% confidence interval [CI] 0.392-1.611), (2) reporting feeling unwell (OR = 1.33, 95% CI 0.118-0.459), and (3) living alone (OR = 2.34, 95% CI 0.115-1.592) were significantly more likely than other participants to experience a hospital visit. Discussion: TIPS demonstrates that community-embedded health services can reduce rates of hospital visits in older adults. Conclusion: The success of TIPS highlights the potential of successfully deployed remote patient-monitoring initiatives in reducing the utilization of costly health services.
Authors: John Morris; Mike Jones; Frank DeRuyter; David Putrino; Catherine E Lang; Danielle Jake-Schoffman Journal: Int J Environ Res Public Health Date: 2019-12-30 Impact factor: 3.390