ICU Telemedicine and Critical Care Mortality
A National Effectiveness Study
Bibliographic Data
| ID | 9097908 |
|---|---|
| Authors | Jeremy M Kahn (0000-0001-9688-5576, Conference Board), Tri Q Le (Conference Board), Amber E Barnato (0000-0003-1080-6270, Conference Board), Marilyn Hravnak (0000-0003-3141-8226, Conference Board), Courtney C Kuza (0000-0001-9137-0928, Conference Board), Francis Pike (Conference Board), Derek C Angus (0000-0002-7026-5181, Conference Board) |
| Year | 2016 |
| Volume | 54 |
| Issue | 3 |
| Pages | 319-325 |
| Publication date | 2016-03-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000485 |
| PMID | 26765148 |
| OpenAlex | W2235966408 |
| Language | EN |
| Citations received | 3 |
| References cited | 29 |
BACKGROUND: Intensive care unit (ICU) telemedicine is an increasingly common strategy for improving the outcome of critical care, but its overall impact is uncertain. OBJECTIVES: To determine the effectiveness of ICU telemedicine in a national sample of hospitals and quantify variation in effectiveness across hospitals. RESEARCH DESIGN: We performed a multicenter retrospective case-control study using 2001-2010 Medicare claims data linked to a national survey identifying US hospitals adopting ICU telemedicine. We matched each adopting hospital (cases) to up to 3 nonadopting hospitals (controls) based on size, case-mix, and geographic proximity during the year of adoption. Using ICU admissions from 2 years before and after the adoption date, we compared outcomes between case and control hospitals using a difference-in-differences approach. RESULTS: A total of 132 adopting case hospitals were matched to 389 similar nonadopting control hospitals. The preadoption and postadoption unadjusted 90-day mortality was similar in both case hospitals (24.0% vs. 24.3%, P=0.07) and control hospitals (23.5% vs. 23.7%, P<0.01). In the difference-in-differences analysis, ICU telemedicine adoption was associated with a small relative reduction in 90-day mortality (ratio of odds ratios=0.96; 95% CI, 0.95-0.98; P<0.001). However, there was wide variation in the ICU telemedicine effect across individual hospitals (median ratio of odds ratios=1.01; interquartile range, 0.85-1.12; range, 0.45-2.54). Only 16 case hospitals (12.2%) experienced statistically significant mortality reductions postadoption. Hospitals with a significant mortality reduction were more likely to have large annual admission volumes (P<0.001) and be located in urban areas (P=0.04) compared with other hospitals. CONCLUSIONS: Although ICU telemedicine adoption resulted in a small relative overall mortality reduction, there was heterogeneity in effect across adopting hospitals, with large-volume urban hospitals experiencing the greatest mortality reductions
Health care · Medical emergency · MEDLINE · Political science · Telemedicine · Emergency Medicine · Healthcare Technology and Patient Monitoring · Medicine · Sepsis Diagnosis and Treatment · Telemedicine and Telehealth Implementation
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| Citations per year | 0.33 |
|---|---|
| Citation span | 2017 - 2025 (9) |
| Highly cited | No |