PCV28 HEALTH-RELATED QUALITY OF LIFE AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ACUTE CORONARY SYNDROMES

PCV23 EVALUATING THE BENEFITS WITH TELECARE AMONG RESIDENTS IN NURSING HOMES IN TAIWAN Hsieh SC, Chang WY, Huang KC, Hsiao J, Chen SC, Hung ST, Tang CH Taipei Medical University, Taipei, Taiwan; Hsiao Chung-Cheng Hospital, Taipei, Taiwan; Taipei County Hospital, Taipei, Taiwan OBJECTIVES: The skyrocketing cost of health care is a crucial issue in Taiwan. This study aimed to evaluate a demonstrative project launched in 2008 whether a telecare management program (T-Care) via internet-based medical tele-consulting, tele-physiological monitoring and health education services, could reduce medical utilization by patients with chronic cardiovascular disease or diabetes mellitus. METHODS: Study subjects were 102 patients residing in two nursing homes located in Keelung City and Taoyuan County, Taiwan. These residents received telecare management services from a district hospital in Taipei County during 2008. National Health Insurance (NHI) Claims data in 2007 and 2008 were gathered on medical utilization. The preand postintervention effects were examined by comparing monthly utilization on inpatient care, outpatient care, emergency rooms care using Two-Part models. Unscheduled medical services were defi ned as utilization of emergency care or inpatient care. RESULTS: Signifi cant decreases were found in the monthly probability of seeking any outpatient visit (92.1 vs. 85.6, P = 0.0035), but decrease in the monthly probability of seeking any emergency care or any inpatient care were not signifi cant. For users of each specifi c care, decrease in number of monthly hospitalizations (1.13 vs. 1.10, P = 0.0987) and number of monthly emergency room visits (1.25 vs. 1.11, P = 0.0547) were found, but decreases in outpatient visits was not signifi cant. Decreases in the total unscheduled NHI resource costs were found (14,548 vs. 14,403). The estimated total annual savings from unscheduled medical services for the study subjects were estimated to be NT$177,627(1 US$ = 31.91 NT$ in 2008). CONCLUSIONS: T-Care may reduce medical costs in patients residing in the nursing homes with reduced rates of readmission to the hospital. Larger clinical trials with larger sample size and controls are warranted to determine the benefi ts of the T-care.