ICD Remote Monitoring Cuts Admissions, Costs but Is Underused: Analysis

Larry Hand

August 24, 2016

DURHAM, NC — Remote monitoring of cardiac implantable electronic devices can reduce hospitalizations and healthcare costs in the US and represents a major opportunity for healthcare quality improvement, according to a new study[1].

Dr Jonathan P Piccini (Duke University Medical Center, Durham, NC) and colleagues used the Truven Health Analytics MarketScan database to conduct a nationwide study of patients who received an implant between March 2009 and April 2012.

They used Cox proportional hazards analyses to compare hospitalization events between patients receiving or not receiving remote monitoring. They also compared healthcare costs for more than 30 days postimplantation.

Of 92,566 adult patients in the analysis (mean age 72, 63% male), 59% had a pacemaker, 30% had an implantable cardioverter defibrillator, and 11% had received cardiac resynchronization therapy (CRT) devices.

Only 37% of patients underwent remote monitoring. Those who did experienced lower hospitalizations during a mean follow-up of 19 months (adjusted hazard ratio 0.82, P<0.001) and shorter lengths of hospital stays (5.3 vs 8.1 days, P<0.001).

The researchers also found remote monitoring to be associated with a 30% reduction in hospitalizations costs, from $12,423 to $8720 mean cost per patient year.

"For every 100,000 patient-years, [remote monitoring] was associated with 9810 fewer hospitalizations, 119,000 fewer days in the hospital, and $370,270,000 lower hospital payments," the researchers wrote.

Among patients with a diagnosis of heart failure, remote monitoring was associated with a shorter length of hospital stay and lower costs. And among patients with a diagnosis of atrial fibrillation, the incidence of hospitalization for stroke was lower among patients who received remote monitoring.

Piccini reported grants from Boston Scientific and St Jude Medical and serving as a consultant to Medtronic; disclosures for the coauthors are listed in the article.

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