{"?xml":{"@version":"1.0"},"edm:RDF":{"@xmlns:dc":"http://purl.org/dc/elements/1.1/","@xmlns:edm":"http://www.europeana.eu/schemas/edm/","@xmlns:wgs84_pos":"http://www.w3.org/2003/01/geo/wgs84_pos","@xmlns:foaf":"http://xmlns.com/foaf/0.1/","@xmlns:rdaGr2":"http://rdvocab.info/ElementsGr2","@xmlns:oai":"http://www.openarchives.org/OAI/2.0/","@xmlns:owl":"http://www.w3.org/2002/07/owl#","@xmlns:rdf":"http://www.w3.org/1999/02/22-rdf-syntax-ns#","@xmlns:ore":"http://www.openarchives.org/ore/terms/","@xmlns:skos":"http://www.w3.org/2004/02/skos/core#","@xmlns:dcterms":"http://purl.org/dc/terms/","edm:WebResource":[{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-JJLECW4G/2a0f4db0-f964-48da-83f5-c7626a1f69a8/PDF","dcterms:extent":"342 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-JJLECW4G/c491b1fb-3894-411a-9334-161a347c71d8/TEXT","dcterms:extent":"0 KB"}],"edm:TimeSpan":{"@rdf:about":"2002-2026","edm:begin":{"@xml:lang":"en","#text":"2002"},"edm:end":{"@xml:lang":"en","#text":"2026"}},"edm:ProvidedCHO":{"@rdf:about":"URN:NBN:SI:doc-JJLECW4G","dcterms:isPartOf":[{"@rdf:resource":"https://www.dlib.si/details/urn:nbn:si:spr-py0w57lr"},{"@xml:lang":"sl","#text":"Zdravstveno varstvo"}],"dcterms:issued":"2024","dc:creator":["Klemenc-Ketiš, Zalika","Mihevc, Matic","Mori-Lukančič, Majda","Petek Šter, Marija","Poplas-Susič, Tonka","Virtič, Tina","Zavrnik, Črt"],"dc:contributor":"Mihevc, Matic","dc:format":[{"@xml:lang":"sl","#text":"številka:1"},{"@xml:lang":"sl","#text":"letnik:63"},{"@xml:lang":"sl","#text":"str. 5-13"}],"dc:identifier":["ISSN:0351-0026","DOI:10.2478/sjph-2024-0002","COBISSID_HOST:179577859","URN:URN:NBN:SI:doc-JJLECW4G"],"dc:language":"en","dc:publisher":{"@xml:lang":"sl","#text":"Nacionalni inštitut za javno zdravje"},"dc:subject":[{"@xml:lang":"en","#text":"costs"},{"@xml:lang":"en","#text":"diabetes"},{"@xml:lang":"en","#text":"elderly"},{"@xml:lang":"sl","#text":"hipertenzija"},{"@xml:lang":"en","#text":"hypertension"},{"@xml:lang":"sl","#text":"primarno zdravstveno varstvo"},{"@xml:lang":"en","#text":"primary care"},{"@xml:lang":"sl","#text":"sladkorna bolezen"},{"@xml:lang":"sl","#text":"starejši"},{"@xml:lang":"sl","#text":"stroški"},{"@xml:lang":"en","#text":"telemonitoring"}],"dcterms:temporal":{"@rdf:resource":"2002-2026"},"dc:title":{"@xml:lang":"sl","#text":"Bottom-up analysis of telemonitoring costs| a case study in slovenian primary care| Analiza stroškov telemonitoringa od spodaj navzgor| študija primera v slovenskem primarnem zdravstvu|"},"dc:description":[{"@xml:lang":"sl","#text":"Introduction: Telemonitoring improves clinical outcomes in patients with arterial hypertension (AH) and type2 diabetes (T2D), however, cost structure analyses are lacking. This study seeks to explore the cost structureof telemonitoring for the elderly with AH and T2D in primary care and identify factors influencing costs forpotential future expansions.Methods: Infrastructure, operational, patient participation, and out-of-pocket costs were determined using abottom-up approach. Infrastructure costs were determined by dividing equipment and telemonitoring platformexpenses by the number of participants. Operational and patient participation costs were determined byconsidering patient training time, data measurement/review time, and teleconsultation time. The change inout-of-pocket costs was assessed in both groups using a structured questionnaire and 12-month expendituredata. Statistical analysis employed an unpaired sample t-test, Mann-Whitney U test, and chi-square test.Results: A total of 117 patients aged 71.4±4.7 years were included in the study. The telemonitoring interventionincurred an annual infrastructure costs of €489.4 and operational costs of €97.3 (95% CI 85.7-109.0) per patient.Patient annual participation costs were €215.6 (95% CI 190.9-241.1). Average annual out-of-pocket costs for bothgroups were €345 (95% CI 221-469). After 12 months the telemonitoring group reported significantly lower out-of-pocket costs (€132 vs. €545, p<0.001), driven by reduced spending on food, dietary supplements, medicalequipment, and specialist check-ups compared to the standard care group.Conclusion: To optimise the cost structure of telemonitoring, strategies like shortening the telemonitoringperiod, developing a national telemonitoring platform, using patient devices, integrating artificial intelligenceinto platforms, and involving nurse practitioners as telemedicine centre coordinators should be explored"},{"@xml:lang":"sl","#text":"Uvod: Telemonitoring predstavlja učinkovit pristop za izboljšanje urejenosti bolnikov z arterijsko hipertenzijo(AH) in sladkorno boleznijo (SB) tipa 2, vendar analize stroškovne strukture niso na voljo. Namen raziskave jeraziskati stroškovno strukturo telemonitoringa pri starejših bolnikih z AH in SB tipa 2 v primarnem zdravstvenemvarstvu in ugotoviti dejavnike, ki vplivajo na stroške za morebitne prihodnje širitve.Metode: S pomočjo pristopa od spodaj navzgor smo ocenili infrastrukturne in operativne stroške, stroškesodelovanja bolnikov in stroške iz žepa. Infrastrukturne stroške smo izračunali tako, da smo stroške nakupatelemedicinske opreme in spletne platforme delili s številom sodelujočih bolnikov. Operativne stroške in stroškesodelovanja bolnikov smo izračunali z upoštevanjem časa za usposabljanje bolnikov, časa za pregled/opravljanjemeritev ter časa za telekonzultacije. Spremembe v stroških iz žepa smo ocenili s pomočjo strukturiranegavprašalnika, v katerem so bolniki v obeh skupinah poročali o stroških iz žepa v preteklem letu. Pri statističnianalizi smo uporabili t-test za neparne vzorce, Mann-Whitneyev U test in hi-kvadrat test.Rezultati: V raziskavo je bilo vključenih 117 bolnikov, starih povprečno 71,4 ± 4,7 leta. Letni infrastrukturnistroški telemonitoringa so znašali 489,4 €, operativni stroški pa 97,3 € (95 % interval zaupanja IZ 85,7–109,0)na bolnika. Letni stroški sodelovanja bolnikov so znašali 215,6 € (95 % IZ 190,9–241,1). Povprečni letni stroški izžepa za obe skupini so znašali 345 € (95 % IZ 221–469). Po 12 mesecih je skupina s telemonitoringom poročalao bistveno nižjih stroških iz žepa (132 € proti 545 €, p < 0,001), pri čemer so se pomembno zmanjšali stroški zahrano in prehranska dopolnila, medicinsko opremo in samoplačniške specialistične preglede.Zaključek: Za optimizacijo stroškovne strukture telemonitoringa je potrebno preučiti strategije, kot so skrajšanjeobdobja telemonitoringa po stabilizaciji kliničnih parametrov, razvoj nacionalne platforme za spremljanje na daljavoz možnostjo prenosa mobilne aplikacije na osebne naprave bolnikov, vključevanje umetne inteligence v spletneplatforme in povečanje vloge diplomirane medicinske sestre na mestu koordinatorja telemedicinskega centra"}],"edm:type":"TEXT","dc:type":[{"@xml:lang":"sl","#text":"znanstveno časopisje"},{"@xml:lang":"en","#text":"journals"},{"@rdf:resource":"http://www.wikidata.org/entity/Q361785"}]},"ore:Aggregation":{"@rdf:about":"http://www.dlib.si/?URN=URN:NBN:SI:doc-JJLECW4G","edm:aggregatedCHO":{"@rdf:resource":"URN:NBN:SI:doc-JJLECW4G"},"edm:isShownBy":{"@rdf:resource":"http://www.dlib.si/stream/URN:NBN:SI:doc-JJLECW4G/2a0f4db0-f964-48da-83f5-c7626a1f69a8/PDF"},"edm:rights":{"@rdf:resource":"http://creativecommons.org/licenses/by-nc-nd/4.0/"},"edm:provider":"Slovenian National E-content Aggregator","edm:intermediateProvider":{"@xml:lang":"en","#text":"National and University Library of Slovenia"},"edm:dataProvider":{"@xml:lang":"sl","#text":"Nacionalni inštitut za javno zdravje"},"edm:object":{"@rdf:resource":"http://www.dlib.si/streamdb/URN:NBN:SI:doc-JJLECW4G/maxi/edm"},"edm:isShownAt":{"@rdf:resource":"http://www.dlib.si/details/URN:NBN:SI:doc-JJLECW4G"}}}}