Evidence map›Paper›PMID 40215100›Full record

ArticleJMIR formative research2025

Cost-Effectiveness Analysis of a Machine Learning-Based eHealth System to Predict and Reduce Emergency Department Visits and Unscheduled Hospitalizations of Older People Living at Home: Retrospective Study.

Charlotte Havreng-Théry, Arnaud Fouchard, Fabrice Denis, Jacques-Henri Veyron, Joël Belmin

Registry-linked trialAbstract readControlled Clinical Trial
In one paragraph

Article in JMIR formative research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05221697 (Effect of an Electronic Alert Management System Using Caregivers' Observations and Machine Learning Algorithm to Reduce the Use of Emergency Department Visits and Unplanned Hospitalizations Among Older People), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05221697 naunknown statusnot on this map

Effect of an Electronic Alert Management System Using Caregivers' Observations and Machine Learning Algorithm to Reduce the Use of Emergency Department Visits and Unplanned Hospitalizations Among Older People

TypeinterventionalSponsorPresageRan2020 to 2024Enrolled800ConditionsEmergenciesArmsPRESAGE CARE
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Charlotte Havreng-ThéryLaboratoire Informatique Médicale et Ingénierie des Connaissances en eSanté, Institut National de la Santé et de la Recherche Médicale and Sorbonne Université, Paris, France.ORCID 0000-0003-1247-5268
Arnaud FouchardEIR Conseil Santé, Antony, France.ORCID 0000-0003-1168-9782
Fabrice DenisInstitut Inter-Régional de Cancérologie Jean Bernard, Le Mans, France.ORCID 0000-0002-2190-7782
Jacques-Henri VeyronPRESAGE, Paris, France.ORCID 0000-0002-3262-266X
Joël BelminLaboratoire Informatique Médicale et Ingénierie des Connaissances en eSanté, Institut National de la Santé et de la Recherche Médicale and Sorbonne Université, Paris, France.ORCID 0000-0003-1630-9582

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDependent older people or those losing their autonomy are at risk of emergency hospitalization. Digital systems that monitor health remotely could be useful in reducing these visits by detecting worsening health conditions earlier. However, few studies have assessed the medico-economic impact of these systems, particularly for older people.

objectiveThe objective of this study was to compare the clinical and economic impacts of an eHealth device in real life compared with the usual monitoring of older people living at home.

methodsThis study was a comparative, retrospective, and controlled trial on data collected between May 31, 2021, and May 31, 2022, in one health care and home nursing center located in Brittany, France. Participants had to be aged >75 years, living at home, and receiving assistance from the home care service for at least 1 month. We implemented among the intervention group an eHealth system that produces an alert for a high risk of emergency department visits or hospitalizations. After each home visit, the home care aides completed a questionnaire on participants' functional status using a smartphone app, and the information was processed in real time by a previously developed machine learning algorithm that identifies patients at risk of an emergency visit within 7 to 14 days. In the case of predicted risk, the eHealth system alerted a coordinating nurse who could then inform the family carer and the patient's nurses or general practitioner.

resultsA total of 120 patients were included in the study, with 60 in the control group and 60 in the intervention group. Among the 726 visits from the intervention group that were not followed by an alert, only 4 (0.6%) resulted in hospitalizations (P<.001), confirming the relevance of the system's alerts. Over the course of the study, 37 hospitalizations were recorded for 25 (20.8%) of the 120 patients. Additionally, of the 120 patients, 9 (7.5%) were admitted to a nursing home, and 7 (5.8%) died. Patients in the intervention group (56/60, 93%) remained at home significantly more often than those in the control group (48/60, 80%; P=.03). The total cost of primary care and hospitalization during the study was €167,000 (€1=US $1.09), with €108,000 (64.81%) attributed to the intervention group (P=.20).

conclusionsThis study presents encouraging results on the impact of a remote medical monitoring system for older adults, demonstrating a reduction in both emergency department visits and hospitalization costs.

trial registrationClinicalTrials.gov NCT05221697; https://clinicaltrials.gov/study/NCT05221697.

Indexed as

Cost-Benefit AnalysisEmergency Service, HospitalHome Care ServicesHospitalizationMachine LearningTelemedicineAgedAged, 80 and overCost-Effectiveness AnalysisEmergency Room VisitsFemaleFranceHumansMaleRetrospective Studiesagingartificial intelligenceBrittanycost-effectivenessdigital healtheHealthelectronic healthemergency departmentemergency department visitemergency visitFrancehealth informaticshome care aideliving at homemachine learningmedico-economicmonitoringnursing homeolder adultpredictive toolremote monitoringretrospective studyunscheduled hospitalization

Identifiers

PMID40215100
PMCPMC12032495

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.