Health Economics & Outcome Research: Open Access

A Cost-Benefit Analysis of Senior Passive Monitoring Technology

Sinan Levy^{* *}Correspondence: Sinan Levy, Editorial office, Health Economics and Outcome Research, Brussels, Belgium, Belgium, Email:

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Introduction

A result of longer life expectancies is a rise in the proportion of older persons who have chronic illnesses and disabilities. Chronic diseases account for around 75% of avoidable medical expenses, and a significant portion of these can be prevented by early diagnosis, followed by monitoring and surveillance. Dementia, stroke, vascular problems of atherosclerosis, osteoarthritis, malignancies, incontinence, osteoporosis, falls, fractures, and bedsores are just a few examples of the numerous age-dependent disorders that can manifest as people age. In addition to functional decline, which results in decreased efficiency, impairment, and low quality of life for older persons, more than 50% of the population of older adults suffers from at least two concurrent chronic diseases. In the elderly, "frailty syndrome" is a significant and increasingly recognised condition. The onset of frailty is accompanied by decreases in energy generation and utilisation as well as the body's "healing mechanisms," which impede the operation of several bodily and physiological systems. Frailty in older persons also increases the risk of serious negative health outcomes, including acute illnesses, falls, disability, use of the Emergency Department (ER), inpatient hospitalisation, institutionalisation, and mortality. The diagnostic criteria for frailty syndrome, for instance, were met by 7% of those over 65% and 30% of people who were 80 years or older in a study of 5000 older adults.

According to some recent scientific studies, using telecare options has financial benefits. For instance, a six-month home telemonitoring programme for patients with Chronic Obstructive Pulmonary Disease (COPD) resulted in a significantly lower number of hospitalizations and nursing home visits among telemonitored patients (p 0.05) and generated savings of $343 per telemonitored patient ($2378) compared to the control group ($2688). For patients with diabetes, a cost analysis employing a telecare system revealed savings of $1065 Per Patient Per Year (PPPY). Hospitalizations are reduced, which accounts for a major portion of the savings attributable to these programmes.

Health-related quality of life is a significant value factor of independent living promoted by PMT, although being challenging to quantify in monetary terms (HRQoL). For instance, Karakaya et al. looked at the differences in functioning and HRQoL between independent living and nursing homes, and they discovered that while nursing home residents typically had greater functioning, they also experienced more depressive symptoms and had poorer total HRQoL. Kostka et al. reported similar findings, finding that HRQoL declined with increasing levels of reliance and institutionalisation. Other research has produced remarkably consistent findings by employing a range of techniques.

The literature consistently demonstrates that older adults who live in the community and use PMT have greater HRQoL scores than older adults who do not.

Concept-Based Structure

The next section explains the economic value framework that was used to pinpoint the primary cost-saving avenues and cost factors associated with independent living supported by PMT in comparison to two other options: independent living supported by the "Standard Of Care" ("SOC") and facilitybased care. Additionally, we presumptively have a target population of "longterm care eligible" people who have mild to moderate comorbidities. These last inclusion criteria were necessary because people with above-average comorbidities would probably need monitoring and care that went beyond PMT (thus, masking the "PMT impact" from other illness management and treatment effects). The possibility of lowering the likelihood of racking up further medical expenses is the second method monitoring systems like PMT add value. Monitoring and signalling have the potential to start healthrelated interventions (from a clinician, a case manager, or an informal caregiver, for example) at less expensive stages, assisting in lowering the need for unnecessary use of more resource-intensive settings, like ERs and inpatient hospitalizations. A related value results from the possibility that LHM will accelerate the response time for "adverse events." Emergency response time, or the interval between the call and arrival at the ER, is strongly correlated with outcomes, including mortality, for some severe occurrences, such as heart attack and stroke.

Enhancing people's HRQoL is the third way that monitoring systems can be valuable. Our hypothesis, which is in line with the literature, is that independent living options, as opposed to institutional care, are associated with greater predicted HRQoL. Specifically, we predict that HRQoL will be highest in the PMT group, greater than or equal to normal in the SOC group, and lowest in the institutional setting group. HRQoL may occasionally be directly incorporated into an economic model by being "mapped" to expenses. HRQoL may also be used to provide "utilities" that are used to weight (or "quality adjust") survival, as measured by life years. Although we do not translate HRQoL data into dollars in our model, we do include it as a descriptive adjunct.