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Interim Results of the Impact of a Digital Health Intervention on Asthma Healthcare Utilization
Monday, March 6, 2017
Exhibit Hall B2 (Georgia World Congress Center, Building B)
Rajan Merchant, MD, Michael Tuffli, Meredith Barrett, PhD, Chris Hogg, David Van Sickle, PhD
Rationale:

Digital health interventions improve asthma outcomes such as adherence, control, and SABA use; however, analyses of their impact on healthcare utilization are limited. We aimed to assess the impact of a digital health intervention, which leveraged sensors and app-based education, on emergency room (ER) visits, hospitalizations and clinic visits.

Methods:

We compared asthma-related (primary ICD-9 493.XX) and non-asthma-related utilization event rates among patients during the intervention period to those during their pre-intervention baseline. We collected utilization data from electronic medical records between July 2012 and September 2015. Differences from baseline in rates per 100 patients per year were assessed using a Wilcoxon Signed Rank test.

Results:

We analyzed data from 330 patients, with an average of 647 baseline and 312 intervention days. All acute asthma-related utilization rates demonstrated significant reductions, including hospitalizations (1.9 to 0; 100% reduction; p<0.01) and ER visits (7.2 to 2.8; 60% reduction; p<0.01). Non-acute asthma-related clinic visits increased (148 to 210; 42% increase; p<0.01). All non-asthma utilization events decreased, including hospitalizations (4.6 to 4.3; 8% reduction; p=0.99), ER visits (37.1 to 28.4; 24% reduction; p=0.10), and clinic visits (630 to 587; 7% reduction; p=0.16); however, none was significant.

Conclusions:

A digital health intervention significantly reduced asthma-related acute healthcare utilization, including ER visits and hospitalizations. An increase in clinic visits suggests providers attempted to address patient worsening in a non-acute setting before an acute exacerbation occurred.