Cost-effectiveness of a new internet-based monitoring tool for neonatal post-discharge home care

Background: the application of information and communication technologies in nursing care is becoming more widespread,but few applications have been reported in neonatal care. a close monitoring of newborns within the first weeks of life is crucial to evaluating correct feeding,growth,and health status. conventional hospital-based postdischarge monitoring could be improved in terms of costs and clinical effectiveness by using a telemedicine approach. objective: to evaluate the cost-effectiveness of a new internet-based system for monitoring low-risk newborns after discharge compared to the standard hospital-based follow-up,with specific attention to prevention of emergency department (ed) visits in the first month of life. methods: we performed a retrospective cohort study of two low-risk newborn patient groups. one group,born between january 1,2011,and june 30,2011,received the standard hospital-based follow-up visit within 48 hours after discharge. after implementing an internet-based monitoring system,another group,born between july 19,2011,and january 19,2012,received their follow-up with this system. results: a total of 18 (15.8%) out of 114 newborns who received the standard hospital-based follow-up had an ed visit in the first month of life compared with 5 (5.6%; p=.026) out of 90 infants who were monitored by the internet-based system. the cost of the hospital-based follow-up was 182.1 per patient,compared with 86.1 for the internet-based follow-up. conclusion: our internet-based monitoring approach proved to be both more effective and less costly than the conventional hospital-based follow-up,particularly through reducing subsequent ed visits.