ABSTRACT
BACKGROUND: The COVID-19 pandemic has caused patients to avoid seeking medical care. Provision of telemonitoring programs in addition to usual care has demonstrated improved effectiveness in managing patients with heart failure (HF). OBJECTIVE: We aimed to examine the potential clinical and health economic outcomes of a telemonitoring program for management of patients with HF during the COVID-19 pandemic from the perspective of health care providers in Hong Kong. METHODS: A Markov model was designed to compare the outcomes of a care under COVID-19 (CUC) group and a telemonitoring plus CUC group (telemonitoring group) in a hypothetical cohort of older patients with HF in Hong Kong. The model outcome measures were direct medical cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio. Sensitivity analyses were performed to examine the model assumptions and the robustness of the base-case results. RESULTS: In the base-case analysis, the telemonitoring group showed a higher QALY gain (1.9007) at a higher cost (US $15,888) compared to the CUC group (1.8345 QALYs at US $15,603). Adopting US $48,937/QALY (1 × the gross domestic product per capita of Hong Kong) as the willingness-to-pay threshold, telemonitoring was accepted as a highly cost-effective strategy, with an incremental cost-effective ratio of US $4292/QALY. No threshold value was identified in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis, telemonitoring was accepted as cost-effective in 99.22% of 10,000 Monte Carlo simulations. CONCLUSIONS: Compared to the current outpatient care alone under the COVID-19 pandemic, the addition of telemonitoring-mediated management to the current care for patients with HF appears to be a highly cost-effective strategy from the perspective of health care providers in Hong Kong.
Subject(s)
Ambulatory Care , COVID-19/complications , Data Analysis , Heart Failure/epidemiology , Monte Carlo Method , Telemedicine/economics , Telemedicine/methods , Ambulatory Care/economics , Ambulatory Care/methods , COVID-19/epidemiology , Cohort Studies , Cost-Benefit Analysis , Hong Kong/epidemiology , Humans , Markov Chains , Pandemics , Quality-Adjusted Life Years , SARS-CoV-2ABSTRACT
The COVID-19 pandemic has far-reaching implications for HRQoL into the future. This disease affects many systems of the body, as well as having an impact on the psychological status of those with the condition, their families, and health care workers. Given the breadth of conditions that may result from COVID-19, it is critical that quality of life researchers begin preparing to address the many factors that may impact HRQoL for many people worldwide.