Topic Area and Motivation: Chronic disease care management in diabetes type II patients, living at home and supported by telemonitoring equipment has proven to be both working and useful while adding health value from a clinical perspective. Managerial decisions need however to be based on quantified cost estimations. The challenge today is to show, in which patient groups, positive cost-benefit results can be obtained by the use of telemedicine equipment.
The problem statement: While numerous studies have shown clinical value and economical benefit separately, there is a need to identify the cost-benefit ratios applicable to different diabetic patient groups, with varying risk levels. The investment costs in expensive telemonitoring equipment need to be compared to associated clinical benefits obtained in the medium and long-term timeframe.
The interest, relevance and importance of the study lays in the cost estimating of care interventions provided to diabetes patient following ‘care pathways’ in home care settings While similar work has been undertaken in the acute care settings with start-end pathways, the cost estimation of the diabetes follow-up is challenged by a recurring loop-back care pathway.
Aims and hypothesis: While it is assumed that the use of telemedicine equipment and related care intervention costs are compensated by a reduction in complications and related health care costs, the aim of the study is to provide a simple model for cost-benefit analysis.
Methods: Workload evaluation methods are used to cost-estimate and cost-quantify identified care pathway variables. The resulting cost information is then used as input data in a simple microsimulation model. Microsimulation is designed to identify the target group of instable diabetic patients for whom the use of telemedicine supported monitoring would produce both clinical added value and be cost-effectiveness as compared to the conventional care delivery model.
Results: The microsimulation model is producing a breakeven point (cost benefit levels reached over determined periods of time) thus identifying parameters about which patient profiles can be cost-beneficially used for the telemedicine modality.
Inhaltsverzeichnis (Table of Contents)
- CHAPTER 1: Traditional care delivery models and chronic disease management
- 1.1. Chronic diseases and the challenge to health systems.
- 1.2. The specific case of Diabetes Disease
- 1.3. Limitations in the care delivery model
- 1.4. Bottlenecks in the care pathway
- 1.5. The need for rethinking
- 1.6. New expectations and requirements
- 1.7. A new variable in the equation: enabling technology
- 1.8. The research issue: Clinical value and economical benefits
- 1.9. Motivation for the research study.
- 1.10. Aims, objectives and outline of the research study
- CHAPTER 2: Literature Review
- 2.1. Focus of the literature review
- 2.2. The framework for chronic care management in diabetes condition
- 2.3. The conventional care delivery and care pathway_
- 2.5. Failing to deliver clinical and economical outcomes
- 2.6. Variables associated to the limitations
- 2.7. The search for solutions
- 2.8. The potential of enabling telemedicine equipment
- 2.9. Telemedicine and Telemonitoring in Diabetes Care
- 2.9.1. Impacts on the clinical side
- 2.9.2. Impacts on the economical side
- 2.10. Bringing together clinical and economical effects
- 2.11. Extrapolation for the research perspective
- CHAPTER 3: Methods
- 3.1. The Research Perspective_
- 3.2. Reasons to choose the case study approach
- 3.3. System analysis
- 3.4. The telemedicine equipment and inbuilt functionalities
- 3.5. Cost-estimation of identified variables in the care pathways
- 3.6. Cost benefit and microsimulation modeling
- CHAPTER 4: Results
- 4.1. The elements of the care delivery model
- 4.2. Care pathway and conventional care delivery model
- 4.3. Assessing the telemedicine equipment
- 4.4. The results produced by the case study
- 4.5. Telemedicine in the conventional care delivery model
- 4.6. Costing data on the conventional and telemedicine care pathways _
- 4.7. Extrapolation of costs and transfer on a simulation model
- 4.8. The findings
- CHAPTER 5: Conclusions, lessons Learnt, Recommandations
- 5.1. Summary and conclusions of the research undertaken
- 5.2. Research work for the future
- 5.3. Recommendations
Zielsetzung und Themenschwerpunkte (Objectives and Key Themes)
This dissertation aims to provide a simple model for cost-benefit analysis in the context of telemonitoring for diabetes care management. It explores the potential benefits of telemedicine equipment in improving clinical outcomes while considering the associated costs. The study focuses on identifying a target group of patients who would benefit most from telemonitoring, both in terms of improved clinical outcomes and cost-effectiveness. The key themes explored in the dissertation include:- The limitations of traditional care delivery models for chronic disease management, particularly diabetes
- The potential of telemedicine equipment to improve clinical outcomes and reduce costs
- The development of a cost-benefit analysis model for telemonitoring in diabetes care management
- The identification of a target group of patients who would benefit most from telemonitoring
- The evaluation of the cost-effectiveness of telemonitoring compared to conventional care delivery models
Zusammenfassung der Kapitel (Chapter Summaries)
- Chapter 1: Traditional care delivery models and chronic disease management: This chapter introduces the challenges of managing chronic diseases, particularly diabetes, within traditional health care systems. It discusses the limitations of existing care delivery models and highlights the need for a new approach that incorporates enabling technologies like telemedicine.
- Chapter 2: Literature Review: This chapter provides a comprehensive overview of the literature on chronic care management in diabetes, focusing on the limitations of traditional care pathways and the potential of telemedicine. It examines the impacts of telemedicine on both the clinical and economical aspects of diabetes care.
- Chapter 3: Methods: This chapter details the research methods employed in the study, including the case study approach and system analysis. It describes the telemedicine equipment used in the study and outlines the process for cost-estimating identified variables in the care pathways. The chapter also explains the development of the cost-benefit and microsimulation models.
- Chapter 4: Results: This chapter presents the findings of the case study, including the elements of the care delivery model, the care pathway, and the assessment of the telemedicine equipment. It also examines the cost data and findings of the simulation model, highlighting the potential benefits of telemedicine for specific patient groups.
Schlüsselwörter (Keywords)
The main keywords and focus topics of the dissertation include telemonitoring, diabetes care management, chronic disease management, cost-benefit analysis, microsimulation, care pathway, clinical outcomes, cost-effectiveness, and telemedicine. These terms encapsulate the primary research areas and concepts explored in the study.- Quote paper
- Marco ZEIMET (Author), 2004, Telemonitoring in Diabetes Care Management, Munich, GRIN Verlag, https://www.grin.com/document/42675
