SAFE@HOME: Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia

Josephus F.M. van den Heuvel; Christiaan van Lieshout; Arie Franx; Geert Frederix; Mireille N. Bekker

doi:10.1016/j.preghy.2021.03.004

SAFE@HOME: Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia

Josephus F.M. van den Heuvel
, Christiaan van Lieshout
, Arie Franx
, Geert Frederix
, Mireille N. Bekker^*

^*Corresponding author for this work

Obstetrics & Gynecology

University Medical Centre Utrecht

Research output: Contribution to journal › Article › Academic › peer-review

21 Citations (Scopus)

102 Downloads (Pure)

Abstract

Objective: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia. Study design: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring. Main outcome measures: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence. Results: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 – 5329] vs €4504 [IQR 3515–6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338–10,173] vs €9150, [IQR 7546–12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources. Conclusion: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.

Original language	English
Pages (from-to)	118-123
Number of pages	6
Journal	Pregnancy Hypertension
Volume	24
DOIs	https://doi.org/10.1016/j.preghy.2021.03.004
Publication status	Published - Jun 2021

Bibliographical note

Funding Information:
None. JFH, CL, GF and MNB designed the study. JFH and MNB were responsible for the acquisition and interpretation of the data. JFH, CL, AF and MNB drafted the manuscript. All authors edited and revised the manuscript. All authors have read and approved the final version of the manuscript. This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). This study was submitted to the Medical Ethics Committee of the University Medical Center in Utrecht (17/424). The committee judged that the Dutch Medical Research Involving Human Subjects Act (WMO) did not apply to this study.

Funding Information:
This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU).

Publisher Copyright:
© 2021 The Authors

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SAFE@HOME Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsiaFinal published version, 965 KBLicence: CC BY

Cite this

@article{22e83bdc6997480899a846deb3d96eeb,

title = "SAFE@HOME: Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia",

abstract = "Objective: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia. Study design: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring. Main outcome measures: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence. Results: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7\% lower compared to the control group (median €3616 [IQR 3071 – 5329] vs €4504 [IQR 3515–6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338–10,173] vs €9150, [IQR 7546–12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources. Conclusion: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.",

author = "\{van den Heuvel\}, \{Josephus F.M.\} and \{van Lieshout\}, Christiaan and Arie Franx and Geert Frederix and Bekker, \{Mireille N.\}",

note = "Funding Information: None. JFH, CL, GF and MNB designed the study. JFH and MNB were responsible for the acquisition and interpretation of the data. JFH, CL, AF and MNB drafted the manuscript. All authors edited and revised the manuscript. All authors have read and approved the final version of the manuscript. This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). This study was submitted to the Medical Ethics Committee of the University Medical Center in Utrecht (17/424). The committee judged that the Dutch Medical Research Involving Human Subjects Act (WMO) did not apply to this study. Funding Information: This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2021",

month = jun,

doi = "10.1016/j.preghy.2021.03.004",

language = "English",

volume = "24",

pages = "118--123",

journal = "Pregnancy Hypertension",

issn = "2210-7789",

publisher = "Elsevier",

}

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T1 - SAFE@HOME

T2 - Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia

AU - van den Heuvel, Josephus F.M.

AU - van Lieshout, Christiaan

AU - Franx, Arie

AU - Frederix, Geert

AU - Bekker, Mireille N.

N1 - Funding Information: None. JFH, CL, GF and MNB designed the study. JFH and MNB were responsible for the acquisition and interpretation of the data. JFH, CL, AF and MNB drafted the manuscript. All authors edited and revised the manuscript. All authors have read and approved the final version of the manuscript. This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). This study was submitted to the Medical Ethics Committee of the University Medical Center in Utrecht (17/424). The committee judged that the Dutch Medical Research Involving Human Subjects Act (WMO) did not apply to this study. Funding Information: This research was funded by the e-Health Citrien Program of the Dutch Federation of University Medical Centers (Nederlandse Federatie van Universitair Medische Centra, NFU). Publisher Copyright: © 2021 The Authors

PY - 2021/6

Y1 - 2021/6

N2 - Objective: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia. Study design: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring. Main outcome measures: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence. Results: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 – 5329] vs €4504 [IQR 3515–6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338–10,173] vs €9150, [IQR 7546–12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources. Conclusion: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.

AB - Objective: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia. Study design: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring. Main outcome measures: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence. Results: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 – 5329] vs €4504 [IQR 3515–6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338–10,173] vs €9150, [IQR 7546–12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources. Conclusion: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.

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JO - Pregnancy Hypertension

JF - Pregnancy Hypertension

ER -

SAFE@HOME: Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia

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