Logo for the Journal of Rehab R and D

Volume 46 Number 5, 2009
   Pages 557 — 566

Abstract – Long-term effect of home telehealth services on preventable hospitalization use

Huanguang Jia, PhD, MPH;1* Ho-Chih Chuang, MS;1-2 Samuel S. Wu, PhD;1-2 Xinping Wang, PhD;1-2 Neale R. Chumbler, PhD3-4

1Department of Veterans Affairs (VA) Rehabilitation Outcomes Research Center, Research Enhancement Award Program, Gainesville, FL; 2Division of Biostatistics, University of Florida College of Medicine, Gainesville, FL;
3VA Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush VA Medical Center,
Indianapolis, IN; 4Department of Sociology, Indiana University School of Liberal Arts, Indiana University-Purdue University Indianapolis, Indianapolis, IN

Abstract — In this study, we assessed the longitudinal effect of a Department of Veterans Affairs (VA) patient-centered Care Coordination Home Telehealth (CCHT) program on preventable hospitalization use by veterans with diabetes mellitus (DM) at four VA medical centers. We used a matched treatment-control design (n = 387 for both groups). All patients were followed for 4 years. We operationalized ambulatory care-sensitive conditions (ACSCs) by applying Agency for Healthcare Research and Quality criteria to VA inpatient databases to determine preventable hospitalization use. We used a generalized linear mixed model to estimate the adjusted effect of the CCHT program on preventable hospitalization use over time. During the initial 18 months of follow-up, CCHT enrollees were less likely to be admitted for a preventable hospitali-zation than their nonenrollee counterparts, and this difference diminished during the rest of the 4-year follow-up period. The VA CCHT program for DM patients reduced preventable hospitalizations. These findings are some of the first that have systematically examined the extent to which home telehealth programs have a long-term effect on preventable hospitalization use.

Key words: ambulatory care-sensitive conditions, cohort study, diabetes mellitus, follow-up study, health services utilization, preventable hospitalization, rehabilitation, telehealth, VA, veterans.

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