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Titolo:
A cost-minimization study of telemedicine - The case of telemonitored polysomnography to diagnose obstructive steep apnea syndrome
Autore:
Pelletier-Fleury, N; Gagnadoux, F; Phillippe, C; Rakotonanahary, D; Lanoe, JL; Fleury, B;
Indirizzi:
INSERM, U537, F-94276 Le Kremlin Bicetre, France INSERM Le Kremlin Bicetre France F-94276 4276 Le Kremlin Bicetre, France Hop Versailles, Serv Pneumol, F-78000 Versailles, France Hop Versailles Versailles France F-78000 mol, F-78000 Versailles, France Hop Tenon, Ctr Explorat Fonctionnelles, F-75020 Paris, France Hop Tenon Paris France F-75020 rat Fonctionnelles, F-75020 Paris, France Hop St Antoine, Unite Sommeil, F-75012 Paris, France Hop St Antoine Paris France F-75012 Unite Sommeil, F-75012 Paris, France
Titolo Testata:
INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE
fascicolo: 4, volume: 17, anno: 2001,
pagine: 604 - 611
SICI:
0266-4623(200123)17:4<604:ACSOT->2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
SLEEP-APNEA; CONSEQUENCES; HOME; VALIDATION;
Keywords:
telemedicine; cost minimization study; obstructive sleep apnea syndrome; polysomnography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Pelletier-Fleury, N INSERM, U537, 80 Rue Gen Leclerc, F-94276 Le Kremlin Bicetre, France INSERM 80 Rue Gen Leclerc Le Kremlin Bicetre France F-94276
Citazione:
N. Pelletier-Fleury et al., "A cost-minimization study of telemedicine - The case of telemonitored polysomnography to diagnose obstructive steep apnea syndrome", INT J TE A, 17(4), 2001, pp. 604-611

Abstract

Objectives: In a context where sleep laboratories are overwhelmed by a growing demand to diagnose obstructive sleep apnea syndrome (OSAS), efficient substitutive solutions to in-laboratory polysomnography should be found. Tocompare the effectiveness and costs of home unattended polysomnography (Hpsg) and telemonitored polysomnography (TMpsg), a cost minimization study was performed. Methods: In a crossover trial, 99 patients underwent on two consecutive nights TMpsg and Hpsg according to a randomized order. A legibility recordingcriterion was retained to measure effectiveness. A microcosting study of TMpsg and Hpsg was performed. The risks to adopt home strategy or telemonitored strategy, according to different scenario chosen to reach the diagnosisin case of failure of Hpsg or TMpsg, were analyzed. Results: The recording was considered to be ineffective in 11.2% of TMpsg (95% Cl, 4.9-17.4) and in 23.4% (95% Cl, 19.12-27.68) of Hpsg. The effectiveness differential was 12.2% (95% Cl, 1.8-22.6) (p = .02). Assuming that incase of failure PSGs would be re-realized in the same condition to reach the diagnosis, then TMpsg could be selected if Hc/TMc (cost of Hpsg/cost of TMpsg) > 0.97; Hpsg could be selected if Hc/TMc < 0.76. If 0.76 less than or equal to Hc/TMc less than or equal to 0.97, the choice of TMpsg would be ambiguous. TMc was estimated to be $244, while Hc was $153 (Hc/TMc = 0.63). Conclusion: Unless some specific geographical situations generate significant transport costs, the implementation of a strategy based on unattended polysomnography at home is cost-saving compared to a telemonitoring strategy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 08:16:35