Evaluation of the Article 51 VIGIE-AGE Experiment: A Significant Impact on Hospitalizations Resulting in Reduced Total Expenditure
Author(s)
Camille Nevoret, PhD1, Elise Cabanes, MD2, Damien Testa, PhD2, Stephane Bouee, MD1, Anne-Sophie Aguade, MSc3, Annie Fouard, MD4, Laura Bezannier, MSc1, Valérie Donio, MSc1.
1CEMKA, Bourg-la-Reine, France, 2EPOCA, Nanterre, France, 3Caisse Nationale d’Assurance Maladie (CNAM), Paris, France, 4Equipa Nationale, Ministère de la Santé, Paris, France.
1CEMKA, Bourg-la-Reine, France, 2EPOCA, Nanterre, France, 3Caisse Nationale d’Assurance Maladie (CNAM), Paris, France, 4Equipa Nationale, Ministère de la Santé, Paris, France.
OBJECTIVES: To assess the effectiveness/efficiency of the Vigie-Age program, a remote monitoring program for people aged 70+ with multiple pathologies and unstable clinical/cognitive conditions that lead to a loss of autonomy. The program enables patients to remain safely at home. The chronic management program (AMAD) is presented here. Vigie-Age is an experiment financed by the French health system innovation fund (named Article51).
METHODS: The evaluation was based on clinical data collected during the program between 2022 and 2024, linked to the French national claims database (SNDS). A comparative analysis of healthcare consumption before and during Vigie-Age was conducted on “mirror-period” (periods of same duration), aligned with the period observed during AMAD program.
RESULTS: Data from 269 patients were analyzed (mean age 88.1±7,0years; 65.1% women, follow-up 7.5 months). Before AMAD treatment, 81.0% of patients had been admitted to hospital for an overnight stay, with 62.1% entering via the emergency department. These figures were 45.4% (p<0.0001) and 29.0% (p<0.0001), respectively, during AMAD. The average number of hospitalisations per patient and their duration remained consistent for hospitalised patients over the two periods. Over the period before AMAD, average expenditure was 13,233€ (ambulatory care: 3,113€ - hospital care: 10,121€), while under AMAD it was 10,639€ (ambulatory care: 4,957€ - hospital care: 5,682€) representing a reduction of 19.6% (p=0.0011). Finally, the scheme resulted in a transfer of costs: from the hospital (-€4,439, a 43.6% reduction) to the city (+1,844€, a 59.2% increase), and to the program (1,678€/patient).
CONCLUSIONS: The Vigie-Age program, for chronic pathways, significantly reduces overnight hospitalisations, including those via the emergency department, resulting in reduced total expenditure. The cost of services associated with the program (including care-managers) is offset by the resulting reduction in healthcare expenditure. The experiment received a favorable opinion from the health authorities towards generalisation.
METHODS: The evaluation was based on clinical data collected during the program between 2022 and 2024, linked to the French national claims database (SNDS). A comparative analysis of healthcare consumption before and during Vigie-Age was conducted on “mirror-period” (periods of same duration), aligned with the period observed during AMAD program.
RESULTS: Data from 269 patients were analyzed (mean age 88.1±7,0years; 65.1% women, follow-up 7.5 months). Before AMAD treatment, 81.0% of patients had been admitted to hospital for an overnight stay, with 62.1% entering via the emergency department. These figures were 45.4% (p<0.0001) and 29.0% (p<0.0001), respectively, during AMAD. The average number of hospitalisations per patient and their duration remained consistent for hospitalised patients over the two periods. Over the period before AMAD, average expenditure was 13,233€ (ambulatory care: 3,113€ - hospital care: 10,121€), while under AMAD it was 10,639€ (ambulatory care: 4,957€ - hospital care: 5,682€) representing a reduction of 19.6% (p=0.0011). Finally, the scheme resulted in a transfer of costs: from the hospital (-€4,439, a 43.6% reduction) to the city (+1,844€, a 59.2% increase), and to the program (1,678€/patient).
CONCLUSIONS: The Vigie-Age program, for chronic pathways, significantly reduces overnight hospitalisations, including those via the emergency department, resulting in reduced total expenditure. The cost of services associated with the program (including care-managers) is offset by the resulting reduction in healthcare expenditure. The experiment received a favorable opinion from the health authorities towards generalisation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD48
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Geriatrics