Objectives: The aim of this study was to systematically investigate existing literature on the costs of home-based telemedicine programs, and to further summarize how the costs of these telemedicine programs vary by equipment and services provided.Methods: We undertook a systematic review of related literature by searching electronic bibliographic databases and identifying studies published from January 1, 2000, to November 30, 2017. The search was restricted to studies published in English, results from adult patients, and evaluation of home telemedicine programs implemented in the United States. Summarized telemedicine costs per unit of outcome measures were reported.Results: Twelve studies were eligible for our review. The overall annual cost of providing home-based telemedicine varied substantially depending on specific chronic conditions, ranging from USD1,352 for heart failure to USD206,718 for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and diabetes as a whole. The estimated cost per-patient-visit ranged from USD24 for cancer to USD39 for CHF, COPD, or chronic wound care.Conclusions: The costs of home-based telemedicine programs varied substantially by program components, disease type, equipment used, and services provided. All the selected studies indicated that home telemedicine programs reduced care costs, although detailed cost data were either incomplete or not presented in detail. A comprehensive analysis of the cost of home-based telemedicine programs and their determinants is still required before the cost efficiency of these programs can be better understood, which becomes crucial for these programs to be more widely adopted and reimbursed.

Background: The study aimed to examine the association between daytime napping and successful aging (including its five dimensions, “low probability of disease,” “no disease-related disability,” “high cognitive functioning,” “high physical functioning,” and “active engagement with life”) among China’s older adults using data from the Chinese Health and Retirement Longitudinal Study conducted in 2015. Methods: Cross-sectional data were used in the analysis. Multivariable logistic regressions were conducted to investigate the association between daytime napping and successful aging, and stratified analyses were performed to explore differences in nighttime sleep duration. Results: A total of 7469 participants were included in the analysis. Daytime napping was prevalent in China’s older adults (59.3%). The proportion of study participants with “successful aging” was 13.7%. Additionally, 48.6, 91.7, 54.1, 78.5, and 49.1% participants achieved “low probability of disease,” “no disease-related disability,” “high cognitive functioning,” “high physical functioning,” and “active engagement with life,” respectively. Compared with the 0 min/day napping group, the > 60 min/day napping group was associated with a lower probability of achieving successful aging (OR, 0.762; 95% CI, 0.583–0.996). In the nighttime sleep duration stratification, the findings showed that in the ≥8 h/night group, napping > 60 min per day was associated with a lower likelihood of aging successfully (OR, 0.617; 95% CI, 0.387–0.984). Considering the five dimensions of successful aging, moderate and long daytime napping were negatively associated with “low probability of disease”; long daytime napping had negative associations with “no disease-related disability” and “high physical functioning”; moderate daytime napping had positive associations with “high cognitive functioning” and “active engagement with life.” Conclusions: Long daytime napping showed a lower likelihood of successful aging among the elderly in China. Special attention is necessary for elderly people who sleep for longer duration both during day and night. Biological and social factors affecting the relationship between daytime napping and successful aging need to be explored in depth in the future.

To explore the relationship between daytime napping and incidence of chronic diseases over the past 6 months among adults in China. Based on data collected from 13,469 respondents over age 40 in the Chinese Family Panel Studies in 2010, logistic regression models were estimated to examine the association between daytime napping and the incidence of any chronic diseases and 3 specific chronic diseases (hypertension, diabetes, and heart disease) after adjusting for confounders. Differences of risks by sex and age were also investigated. In the sample, 50.8% were women and 32.2% were over 60 years old. Adjusted estimates show respondents with daytime napping had elevated odds of developing any chronic diseases, hypertension, and diabetes compared to those who did not nap; having over 60 minutes of daytime napping had weaker association compared with shorter duration of daytime napping. The association between daytime napping and hypertension was found in women but not in men. Daytime napping appears to be associated with elevated risk of incidence of any chronic diseases, hypertension, and diabetes.

Undiagnosed hypertension has resulted in significant health and economic burdens. This study sought to investigate the association between health factors and undiagnosed hypertension among hypertensive Chinese and to assess the urban-rural disparity. A total of 6455 diagnosed and undiagnosed hypertensive adults were included. Multivariable logistic regression was conducted to examine the association between health factors and undiagnosed hypertension. The urban–rural disparity was investigated through stratified analysis. Undiagnosed hypertension was prevalent (28.8%), and rural residents were more likely to have undiagnosed hypertension compared to their urban counterparts (30.1% versus 24.7%). Physical examination, healthcare service utilization, body mass index, chronic diseases, headache, and self-rated health status were found to be significantly associated with undiagnosed hypertension. In addition, healthcare service utilization, underweight in body mass index, headache, and self-rating health status were associated with undiagnosed hypertension among the rural sample but not in the urban sample. Undiagnosed hypertension was significantly related to health factors among hypertensive Chinese. The findings provided implications for future hypertension prevention programs. The use of physical examination (e.g., blood pressure measurements) is recommended; special attention may be given to those who are underweight and self-rate their health as good and fair, as they are more likely to be neglected.