J. Med. Internet Res. - Cost-effectiveness of a new internet-based monitoring tool for neonatal post-discharge home care.

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Resumo

CKGROUND: The application of information and communication technologies in nursing care is becoming more widespread, but few applications have been reported in neonatal care. A close monitoring of newborns within the first weeks of life is crucial to evaluating correct feeding, growth, and health status. Conventional hospital-based postdischarge monitoring could be improved in terms of costs and clinical effectiveness by using a telemedicine approach.OBJECTIVE: To evaluate the cost-effectiveness of a new Internet-based system for monitoring low-risk newborns after discharge compared to the standard hospital-based follow-up, with specific attention to prevention of emergency department (ED) visits in the first month of life.METHODS: We performed a retrospective cohort study of two low-risk newborn patient groups. One group, born between January 1, 2011, and June 30, 2011, received the standard hospital-based follow-up visit within 48 hours after discharge. After implementing an Internet-based monitoring system, another group, born between July 19, 2011, and January 19, 2012, received their follow-up with this system.RESULTS: A total of 18 (15.8%) out of 114 newborns who received the standard hospital-based follow-up had an ED visit in the first month of life compared with 5 (5.6%; P=.026) out of 90 infants who were monitored by the Internet-based system. The cost of the hospital-based follow-up was 182.1? per patient, compared with 86.1? for the Internet-based follow-up.CONCLUSION: Our Internet-based monitoring approach proved to be both more effective and less costly than the conventional hospital-based follow-up, particularly through reducing subsequent ED visits.

Resumo Limpo

ckground applic inform communic technolog nurs care becom widespread applic report neonat care close monitor newborn within first week life crucial evalu correct feed growth health status convent hospitalbas postdischarg monitor improv term cost clinic effect use telemedicin approachobject evalu costeffect new internetbas system monitor lowrisk newborn discharg compar standard hospitalbas followup specif attent prevent emerg depart ed visit first month lifemethod perform retrospect cohort studi two lowrisk newborn patient group one group born januari june receiv standard hospitalbas followup visit within hour discharg implement internetbas monitor system anoth group born juli januari receiv followup systemresult total newborn receiv standard hospitalbas followup ed visit first month life compar p infant monitor internetbas system cost hospitalbas followup per patient compar internetbas followupconclus internetbas monitor approach prove effect less cost convent hospitalbas followup particular reduc subsequ ed visit

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