The effect of telephone health coaching and remote exercise monitoring for peripheral artery disease (TeGeCoach) on health care cost and utilization: results of a randomized controlled trial

Dirk Heider (), Farhad Rezvani, Herbert Matschinger, Jörg Dirmaier, Martin Härter, Lutz Herbarth, Patrick Steinisch, Hannes Böbinger, Franziska Schuhmann, Gundula Krack, Thomas Korth, Lara Thomsen, Daniela Patricia Chase, Robert Schreiber, Mark-Dominik Alscher, Benjamin Finger and Hans-Helmut König
Additional contact information
Dirk Heider: University Medical Center Hamburg-Eppendorf
Farhad Rezvani: University Medical Center Hamburg-Eppendorf
Herbert Matschinger: University Medical Center Hamburg-Eppendorf
Jörg Dirmaier: University Medical Center Hamburg-Eppendorf
Martin Härter: University Medical Center Hamburg-Eppendorf
Lutz Herbarth: KKH Kaufmännische Krankenkasse Statutory Health Insurance
Patrick Steinisch: KKH Kaufmännische Krankenkasse Statutory Health Insurance
Hannes Böbinger: TK Techniker Krankenkasse Statutory Health Insurance
Franziska Schuhmann: TK Techniker Krankenkasse Statutory Health Insurance
Gundula Krack: mhplus Krankenkasse Statutory Health Insurance
Thomas Korth: IEM GmbH
Lara Thomsen: Philips GmbH
Daniela Patricia Chase: Philips GmbH
Robert Schreiber: Philips GmbH
Mark-Dominik Alscher: Robert Bosch Gesellschaft Für Medizinische Forschung mbH, Bosch-Institute of Clinical Pharmacology
Benjamin Finger: Robert Bosch Gesellschaft Für Medizinische Forschung mbH, Bosch-Institute of Clinical Pharmacology
Hans-Helmut König: University Medical Center Hamburg-Eppendorf

The European Journal of Health Economics, 2024, vol. 25, issue 4, No 5, 615-629

Abstract: Abstract Background Peripheral artery disease (PAD) is the third most prevalent atherosclerotic cardiovascular disease. In 2016, costs per patient associated with PAD exceeded even the health-economic burden of coronary heart disease. Although affecting over 200 million people worldwide, a clear consensus on the most beneficial components to be included in home-based exercise programs for patients with peripheral artery disease is lacking. The aim of the study was to examine the health care use and costs caused by the 12-month patient-centered ‘Telephone Health Coaching and Remote Exercise Monitoring for Peripheral Artery Disease’ (TeGeCoach) program in a randomized controlled trial. Methods This is a two-arm, parallel-group, open-label, pragmatic, randomized, controlled clinical trial (TeGeCoach) at three German statutory health insurance funds with follow-up assessments after 12 and 24-months. Study outcomes were medication use (daily defined doses), days in hospital, sick pay days and health care costs, from the health insurers’ perspective. Claims data from the participating health insurers were used for analyses. The main analytic approach was an intention-to-treat (ITT) analysis. Other approaches (modified ITT, per protocol, and as treated) were executed additionally as sensitivity analysis. Random-effects regression models were calculated to determine difference-in-difference (DD) estimators for the first- and the second year of follow-up. Additionally, existing differences at baseline between both groups were treated with entropy balancing to check for the stability of the calculated estimators. Results One thousand six hundred eighty-five patients (Intervention group (IG) = 806; Control group (CG) = 879) were finally included in ITT analyses. The analyses showed non-significant effects of the intervention on savings (first year: − 352€; second year: − 215€). Sensitivity analyses confirmed primary results and showed even larger savings. Conclusion Based on health insurance claims data, a significant reduction due to the home-based TeGeCoach program could not be found for health care use and costs in patients with PAD. Nevertheless, in all sensitivity analysis a tendency became apparent for a non-significant cost reducing effect. Trial registration NCT03496948 (www.clinicaltrials.gov), initial release on 23 March 2018

Keywords: Peripheral artery disease; Home-based exercise program; Randomised controlled trial; Intention-to-treat; Health care use and costs (search for similar items in EconPapers)
JEL-codes: I (search for similar items in EconPapers)
Date: 2024
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s10198-023-01616-4 Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:eujhec:v:25:y:2024:i:4:d:10.1007_s10198-023-01616-4

Ordering information: This journal article can be ordered from
http://www.springer. ... cs/journal/10198/PS2

DOI: 10.1007/s10198-023-01616-4

Access Statistics for this article

The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg

More articles in The European Journal of Health Economics from Springer, Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ) Contact information at EDIRC.
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().