Article Instance
API Endpoint for journals.
GET /api/articles/48521/?format=api
{ "pk": 48521, "title": "A Cost Analysis of Mobile Integrated Health for Acute Care", "subtitle": null, "abstract": "<p><strong>Objectives:</strong> Mobile integrated health programs have emerged as a means to reduce avoidable emergency department (ED) visits and optimize healthcare resource utilization. Such models are estimated to cost less than ED encounters but may be more costly than traditional ambulatory services. However, mobile integrated health is not reimbursed by most payors, and its operational costs are poorly understood. Our objective if this study was to estimate the costs of delivering acute care services through a mobile integrated health program.</p>\n<p><strong>Methods:</strong> This study was performed at an urban academic tertiary care center with a hospital-affiliated emergency medical services agency in which a mobile integrated health program is embedded. Home visits are conducted by paramedics who collaborate with a remotely located, actively engaged physician to evaluate and treat patients. We compiled cost data derived from real-world mobile integrated health patient encounters to account for all the resources needed to perform acute care visits. Mobile integrated health visits were categorized as basic, involving lower complexity evaluations with limited diagnostics, or advanced, which include higher acuity care with intravenous medications and multiple diagnostic studies. We used Monte Carlo simulations to provide probabilistic estimates of the cost per visit of mobile integrated health-facilitated care. </p>\n<p><strong>Results:</strong> Using a Monte Carlo simulation with 1,000 iterations, we established cost estimates for basic and advanced service categories of mobile integrated health services. The median cost of a basic call is $550 (90% CI [$512–$676]), and $1400.00 for an advanced call (90% CI [$810–$1,813]). </p>\n<p><strong>Conclusion: </strong>This project, which generated real-world cost estimates for mobile integrated health programs delivering acute care services, offers essential context for policymakers and payors evaluating sustainable reimbursement models. We estimate that mobile integrated health services cost more than the mean cost of most outpatient clinic visits ($160) but remain substantially less expensive than emergency department visits ($2,715) or inpatient admissions ($24,680). These findings should be interpreted with caution, given the limitations of simulation-based estimates in a single system. They highlight the ongoing need to prospectively and rigorously assess the cost-effectiveness of mobile integrated health models.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Mobile Integrated Health; Prehospital Care" }, { "word": "emergency medical services" }, { "word": "Health Economics" } ], "section": "Emergency Department Access", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8p98b057", "frozenauthors": [ { "first_name": "Laurel", "middle_name": "", "last_name": "O'Connor", "name_suffix": "", "institution": "University of Massachusetts Chan Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "" }, { "first_name": "Olivia", "middle_name": "", "last_name": "Dunn", "name_suffix": "", "institution": "Worcester Polytechnic Institute, School of Business, Worcester, Massachusetts", "department": "" }, { "first_name": "Sophia", "middle_name": "", "last_name": "Merolle", "name_suffix": "", "institution": "Worcester Polytechnic Institute, School of Business, Worcester, Massachusetts", "department": "" }, { "first_name": "Cosette", "middle_name": "", "last_name": "Salaun", "name_suffix": "", "institution": "Worcester Polytechnic Institute, School of Business, Worcester, Massachusetts", "department": "" }, { "first_name": "Bettina", "middle_name": "", "last_name": "Valentiner", "name_suffix": "", "institution": "Worcester Polytechnic Institute, School of Business, Worcester, Massachusetts", "department": "" }, { "first_name": "Joel", "middle_name": "", "last_name": "Rowe", "name_suffix": "", "institution": "University of Florida, Department of Emergency Medicine, Gainesville, Florida", "department": "" }, { "first_name": "Alexander", "middle_name": "", "last_name": "Ulintz", "name_suffix": "", "institution": "The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio", "department": "" }, { "first_name": "Timothy", "middle_name": "", "last_name": "Boardman", "name_suffix": "", "institution": "University of Massachusetts Chan Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "" }, { "first_name": "Jan", "middle_name": "M.", "last_name": "Otero", "name_suffix": "", "institution": "Fire Division, Lake County Board of County Commissioners, Mascotte, Florida", "department": "" }, { "first_name": "Martin", "middle_name": "", "last_name": "Reznek", "name_suffix": "", "institution": "University of Massachusetts Chan Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "" }, { "first_name": "Scott", "middle_name": "A.", "last_name": "Goldberg", "name_suffix": "", "institution": "Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Renata", "middle_name": "", "last_name": "Konrad", "name_suffix": "", "institution": "Worcester Polytechnic Institute, School of Business, Worcester, Massachusetts", "department": "" } ], "date_submitted": "2025-06-10T11:07:02.541000-07:00", "date_accepted": "2025-11-20T16:51:06.966000-08:00", "date_published": "2026-02-12T10:08:00-08:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48521/galley/49070/download/" } ] }