Journal of Telemedicine and Telecare > Volume 15, Number 2 > Pp. 98-101

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RESEARCH Original articles

Mortality risk for diabetes patients in a care coordination, home-telehealth programme

Neale R Chumbler ^*  , Ho-Chih Chuang , Samuel S Wu  , Xinping Wang , Rita Kobb ^**, David Haggstrom ^*   and Huanguang Jia 

^* Department of Veterans Affairs Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice, Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana; Department of Sociology, Indiana University School of Liberal Arts, Indiana University, Indianapolis, Indiana; Department of Veterans Affairs Health Services Research and Development/Rehabilitation Research and Development Rehabilitation Outcomes Research Center Research Enhancement Award Program, Gainesville, Florida; Department of Epidemiology and Health Policy Research, University of Florida, College of Medicine, Gainesville, Florida; ^** Office of Care Coordination, Veterans Health Administration, Lake City, Florida; Center for Health Services and Outcomes Research, Regenstrief Institute, Indiana University, Indianapolis, Indiana; Department of Internal Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA

Correspondence: Dr Neale R Chumbler, VA HSR&D Center on Implementing Evidence-Based Practice, Roudebush VAMC, 1481 West Tenth Street, 11-H, Indianapolis, IN 46202, USA (Fax: +1 317 988 4493; Email: nchumble{at}iupui.edu)

We assessed a home monitoring/care coordination programme for veterans with diabetes. Patients enrolled in the programme (n = 387) were followed for four years and compared with a retrospective control group (n = 387). Each patient in the intervention group used a messaging device in the home that was connected by a conventional telephone line. Care coordinators monitored the answers from the devices daily so that early interventions could be made. There were significantly more deaths in the control group (n = 102, 26%) compared with the intervention group (n = 75, 19%). There was longer survival for the intervention group versus the control group (mean survival time 1348 vs 1278 days; P = 0.015). A multivariate analyses indicated that the telemonitoring programme was associated with reduced 4-year all-cause mortality (hazard ratio = 0.7, 95% CI 0.5–0.9, P = 0.013). The results suggest that daily management of patients with diabetes through home monitoring by a registered nurse reduces mortality.

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