ICU Telemedicine and Critical Care Mortality: A National Effectiveness Study

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 effectivenes...

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Bibliographic Details
Published in:Medical care 2016-03, Vol.54 (3), p.319-325
Main Authors: Kahn, Jeremy M., Le, Tri Q., Barnato, Amber E., Hravnak, Marilyn, Kuza, Courtney C., Pike, Francis, Angus, Derek C.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Case-Control Studies
Comorbidity
Diagnosis-Related Groups
Female
Hospital Mortality - trends
Hospitals
Hospitals, High-Volume - statistics & numerical data
Humans
Intensive care
Intensive Care Units - statistics & numerical data
Length of Stay - statistics & numerical data
Male
Medicare - statistics & numerical data
Mortality
Original Article
Patient Discharge - statistics & numerical data
Residence Characteristics
Retrospective Studies
Telemedicine
Telemedicine - statistics & numerical data
United States
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Summary: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
ISSN:0025-7079
1537-1948
DOI:10.1097/MLR.0000000000000485