Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review
Open accessAbstract
OBJECTIVE: A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. MATERIALS AND METHODS: Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. RESULTS: The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. CONCLUSIONS: There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.
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One review concluded that remote monitoring and video consultations could potentially be cost-effective from a provider perspective, but insufficient high-quality evidence precluded a more certain conclusion.
“The second review concluded that remote monitoring and video consultations could potentially be cost-effective from a provider perspective, however insufficient high-quality evidence precluded a more certain conclusion [68].”
From Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation (2020) · cites this paper as [68]
The Discussion and Conclusions (page unavailable) says most studies found telemedicine cost-effective, but identifies limitations in the quality of economic evaluations and reports that earlier reviews found no conclusive evidence. It does not make the narrower conclusion about remote monitoring and video consultations from a provider perspective. (LLM, conf=0.85)
Experimental — accuracy not yet measuredRelevant information uploaded in real-time via digital technology potentially reduces time and economic costs for both patients and healthcare workers.
“Relevant information is uploaded in real-time via digital technology, potentially reducing time and economic costs for both patients and healthcare workers (34).”
From The effectiveness of digital health intervention on glycemic control and physical activity in patients with type 2 diabetes: a systematic review and meta-analysis (2025) · cites this paper as [34]
The introduction (page not specified in our copy) says that most cost-effectiveness studies demonstrate telemedicine can reduce costs, and the Results describe a telemedicine service that cost less than face-to-face delivery. The paper does not establish that real-time uploading of information reduces time or that the economic savings accrue to both patients and healthcare workers. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThere is a large gap in the literature analysing the costs and cost-effectiveness of mHealth interventions addressing T2DM.
“Nevertheless, there is a large gap in the literature analysing the costs and cost-effectiveness of mHealth interventions addressing T2DM [20].”
From Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: A systematic review (2020) · cites this paper as [20]
Few studies effectively analyzed the economic validity of tele-dermatology, and more randomized control trials with larger sample sizes and appropriate tools of measurement must be completed before accurate conclusions can be made.
“de la Torre-Diez et al. found that few studies effectively analyzed the economic validity of tele-dermatology. They concluded that a need for more randomized control trials with larger sample sizes and appropriate tools of measurement must be completed before accurate conclusions can be made.”
From Patient and practitioner satisfaction with tele-dermatology including Australia’s indigenous population: A systematic review of the literature (2016) · cites this paper as de la Torre-Diez et al., 2015
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- Authors
- de la Torre-Díez, I., López-Coronado, M., Vaca, C., Aguado, J. S., & de Castro, C.
- Affiliations
- University of Valladolid
- Universidad de Valladolid (ES)
- University of Cordoba
- Venue
- Telemedicine and e-Health
- Publisher
- SAGE Publications
- Published
- 2015-02
- Volume
- 21
- Issue
- 2
- Pages
- 81-85
- ISSN
- 1530-5627 (ISSN-L)
- 1556-3669
- PMC
- PMC4312789
- OpenAlex
- W2335342262
- Cited by
- 495
- References
- 34
- Citations by year
- 2026: 13 · 2025: 29 · 2024: 39 · 2023: 53 · 2022: 82 · 2021: 86 · 2020: 65 · 2019: 47 · 2018: 33 · 2017: 25 · 2016: 18 · 2015: 4
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Telemedicine Journal and e-Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Valladolid Documentary Repository (University of Valladolid) (submittedVersion, cc-by-nc-nd)
- Funders
- European Commission (AAL-20125036)
- Ministerio de Industria, Energía y Turismo (AAL-20125036)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- telemedicine, e-health, mobile health, cost-utility analysis, cost-effectiveness, economic evaluation, teleophthalmology, telecardiology, teledermatology
- MeSH terms
- Cost-Benefit Analysis, Humans, Telemedicine, Electronic Health Records
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