Impact of Telemedicine on Mortality, Length of Stay, and Cost Among Patients in Progressive Care Units: Experience From a Large Healthcare System*
Open accessAbstract
Objectives: To determine whether Telemedicine intervention can affect hospital mortality, length of stay, and direct costs for progressive care unit patients. Design: Retrospective observational. Setting: Large healthcare system in Florida. Patients: Adult patients admitted to progressive care unit (PCU) as their primary admission between December 2011 and August 2016 (n = 16,091). Interventions: Progressive care unit patients with telemedicine intervention (telemedicine PCU [TPCU]; n = 8091) and without telemedicine control (nontelemedicine PCU [NTPCU]; n = 8000) were compared concurrently during study period. Measurements and Main Results: Primary outcome was progressive care unit and hospital mortality. Secondary outcomes were hospital length of stay, progressive care unit length of stay, and mean direct costs. The mean age NTPCU and TPCU patients were 63.4 years (95% CI, 62.9–63.8 yr) and 71.1 years (95% CI, 70.7–71.4 yr), respectively. All Patient Refined-Diagnosis Related Group Disease Severity (p < 0.0001) and All Patient Refined-Diagnosis Related Group patient Risk of Mortality (p < 0.0001) scores were significantly higher among TPCU versus NTPCU. After adjusting for age, sex, race, disease severity, risk of mortality, hospital entity, and organ systems, TPCU survival benefit was 20%. Mean progressive care unit length of stay was lower among TPCU compared with NTPCU (2.6 vs 3.2 d; p < 0.0001). Postprogressive care unit hospital length of stay was longer for TPCU patients, compared with NTPCU (7.3 vs 6.8 d; p < 0.0001). The overall mean direct cost was higher for TPCU ($13,180), compared with NTPCU ($12,301; p < 0.0001). Conclusions: Although there are many studies about the effects of telemedicine in ICU, currently there are no studies on the effects of telemedicine in progressive care unit settings. Our study showed that TPCU intervention significantly decreased mortality in progressive care unit and hospital and progressive care unit length of stay despite the fact patients in TPCU were older and had higher disease severity, and risk of mortality. Increased postprogressive care unit hospital length of stay and total mean direct costs inclusive of telemedicine costs coincided with improved survival rates. Telemedicine intervention decreased overall mortality and length of stay within progressive care units without substantial cost incurrences.
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Length of stay in the ICU could be reduced through the utilization of remote patient monitoring.
“ICU staff claimed that the length of stay in the ICU could be reduced through the utilization of remote patient monitoring, which is in line with several recent studies on telemedicine [44,45].”
From Clinical requirements of future patient monitoring in the intensive care unit: qualitative study (2019) · cites this paper as [44]
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Clinical requirements of future patient monitoring in the intensive care unit: qualitative study
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- Authors
- Armaignac, D. L., Saxena, A., Rubens, M., Valle, C. A., Williams, L.-M. S., Veledar, E., & Gidel, L. T.
- Affiliations
- Baptist Health South Florida (US)
- Corresponding author
- Armaignac, Donna Lee
- Venue
- Critical Care Medicine
- Published
- 2018-05
- Volume
- 46
- Issue
- 5
- Pages
- 728-735
- ISSN
- 0090-3493 (ISSN-L)
- PMC
- PMC5908255
- OpenAlex
- W2786030699
- Cited by
- 86
- References
- 48
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 8 · 2023: 10 · 2022: 9 · 2021: 17 · 2020: 9 · 2019: 16 · 2018: 2
- FWCI
- 10.49
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Critical Care Medicine (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Florida International University Digital Commons (Florida International University) (submittedVersion, cc-by-nc-nd)
- Scholarly Commons - Baptist Health South Florida (Baptist Health South Florida) (submittedVersion, cc-by-nc-nd)
- Scholarly Commons - Baptist Health South Florida (Baptist Health South Florida) (submittedVersion)
- Florida International University Digital Commons (Florida International University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- telemedicine, progressive care unit, in-hospital mortality, length of hospital stay, hospital costs, patient survival, hospital readmission, nosocomial infections
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Length of Stay, Male, Middle Aged, Progressive Patient Care, Retrospective Studies, Hospital Mortality, Telemedicine, Hospital Costs, Young Adult
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