Abstract
BACKGROUND: Digital remote patient monitoring (RPM) enables longitudinal care outside traditional healthcare settings, especially in the vulnerable period after hospitalizations, with broad coverage of the service by payers. We sought to evaluate patterns of RPM service availability at US hospitals and the characteristics of hospitals and the communities they serve that are associated with the availability of these services. METHODS: We used contemporary national data from the American Hospital Association (AHA) Annual Survey to ascertain US hospitals offering RPM services for post-discharge or chronic care. We linked hospitals with their census-based county-level data to define the characteristics of the communities they serve and examined the association of these characteristics with RPM availability. We also conducted an exploratory analysis quantifying the number of patients with key cardiovascular conditions of heart failure (HF) and acute myocardial infarction (AMI) receiving care at hospitals providing RPM services. RESULTS: The study included 5,644 hospitals. Over five years of study, there was a 40.3% increase in the number of hospitals offering RPM services, rising from 1,364 (33.0%) hospitals in 2018 to 1,797 (46.3%) in 2022. However, the availability of RPM services varied across different hospital groups, with smaller, non-teaching, rural, and hospitals serving low-income communities, particularly in the South, being less likely to offer RPM. Hospitals with more than 300 beds had 3.7-fold odds of offering RPM compared with those with less than 100 beds (aOR 3.71, 95% CI 2.90-4.74). Non-teaching hospitals had a 70% lower likelihood of RPM availability (aOR 0.29, 95% CI 0.19-0.44), and rural hospitals had 50% lower odds compared with urban hospitals (aOR 0.49, 95% CI 0.32-0.77). CONCLUSIONS: In this national study of US hospitals, there has been a large increase in the availability of RPM services but with large variation among hospitals, with lower availability in hospitals serving low-income and rural communities.