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A systematic review of economic analyses of telehealth services using real time video communication
Open accessAbstract
BACKGROUND: Telehealth is the delivery of health care at a distance, using information and communication technology. The major rationales for its introduction have been to decrease costs, improve efficiency and increase access in health care delivery. This systematic review assesses the economic value of one type of telehealth delivery--synchronous or real time video communication--rather than examining a heterogeneous range of delivery modes as has been the case with previous reviews in this area. METHODS: A systematic search was undertaken for economic analyses of the clinical use of telehealth, ending in June 2009. Studies with patient outcome data and a non-telehealth comparator were included. Cost analyses, non-comparative studies and those where patient satisfaction was the only health outcome were excluded. RESULTS: 36 articles met the inclusion criteria. 22(61%) of the studies found telehealth to be less costly than the non-telehealth alternative, 11(31%) found greater costs and 3 (9%) gave the same or mixed results. 23 of the studies took the perspective of the health services, 12 were societal, and one was from the patient perspective. In three studies of telehealth to rural areas, the health services paid more for telehealth, but due to savings in patient travel, the societal perspective demonstrated cost savings. In regard to health outcomes, 12 (33%) of studies found improved health outcomes, 21 (58%) found outcomes were not significantly different, 2(6%) found that telehealth was less effective, and 1 (3%) found outcomes differed according to patient group. The organisational model of care was more important in determining the value of the service than the clinical discipline, the type of technology, or the date of the study. CONCLUSION: Delivery of health services by real time video communication was cost-effective for home care and access to on-call hospital specialists, showed mixed results for rural service delivery, and was not cost-effective for local delivery of services between hospitals and primary care.
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“Economic analyses have shown that cost effectiveness of synchronous telemedicine vary widely according to the delivery setting [8].”
From Recent directions in telemedicine: Review of trends in research and practice (2015) · cites this paper as [8]
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“It was previously known as telemedicine, and these terms continue to be used interchangeably in the literature.(37) Most European countries report use of telehealth technology; however, this tends to be on a small and experimental level.”
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“These savings could enable consultants to see more patients in a day, improving patient access and health system efficiency, an observation mirrored by others [30, 34].”
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Tao, K. F. M., Brennan‐Jones, C. G., Capobianco, D. M., Jayakody, D. M. P., Friedland, P. L., Swanepoel, D. W., & Eikelboom, R. H. (2018) · Journal of Speech Language and Hearing Research · doi:10.1044/2018_jslhr-h-16-0397 · Cited by 58
Telemedicine in chronic obstructive pulmonary disease
Ambrosino, N., Vagheggini, G., Mazzoleni, S., & Vitacca, M. (2016) · Breathe · doi:10.1183/20734735.014616 · Cited by 56
“A systematic review assessed the economic value of synchronous or real-time video communication, and concluded that these tools were cost-effective for local delivery of services between hospitals and primary care [36].”
BackgroundBenefits and limitations of telegenetics: A literature review
Gorrie, A., Gold, J., Cameron, C. A., Krause, M., & Kincaid, H. (2021) · Journal of Genetic Counseling · doi:10.1002/jgc4.1418 · Cited by 60
Darkins, A. W. (2016) · Cambridge University Press eBooks · doi:10.1017/cbo9781139629317.029 · Cited by 57
Digital Literacy 5.0 to Enhance Multicultural Education
Anurogo, D., Ramba, H. L., Putri, N. D., & Putri, U. M. P. (2023) · Multicultural Islamic Education Review · doi:10.23917/mier.v1i2.3414 · Cited by 103
Byaruhanga, J., Atorkey, P., McLaughlin, M. J., Brown, A., Byrnes, E., Paul, C. L., Wiggers, J., & Tzelepis, F. (2020) · Journal of Medical Internet Research · doi:10.2196/18621 · Cited by 60
“Real-time video technology allows a real-time, virtual face-to-face interaction between the provider and the user [12] at any time of the day in any location with internet access [13].”
BackgroundOtten, E., Birnie, E., Ranchor, A. V., & van Langen, I. M. (2016) · European Journal of Human Genetics · doi:10.1038/ejhg.2015.283 · Cited by 53
Giacalone, A., Marin, L., Febbi, M., Franchi, T., & Palone, M. R. T. (2022) · World Journal of Clinical Cases · doi:10.12998/wjcc.v10.i8.2363 · Cited by 57
What drives E-Health usage? Integrated institutional forces and top management perspectives
Hsia, T.-L., Chiang, A., Wu, J., Teng, N. N. H., & Rubin, A. D. (2019) · Computers in Human Behavior · doi:10.1016/j.chb.2019.01.010 · Cited by 54
Adams, L., Lester, S., Hoon, E., van der Haak, H., Proudman, C., Hall, C., Whittle, S., Proudman, S., & Hill, C. L. (2021) · Internal Medicine Journal · doi:10.1111/imj.15205 · Cited by 46
Quantifying the Societal Benefits From Telehealth: Productivity and Reduced Travel
Snoswell, C. L., Smith, A. C., Page, M. J., Scuffham, P., & Caffery, L. J. (2021) · Value in Health Regional Issues · doi:10.1016/j.vhri.2021.07.007 · Cited by 54
Outpatient services and primary care: scoping review, substudies and international comparisons
Winpenny, E. M., Miani, C., Pitchforth, E., Ball, S. L., Nolte, E., King, S., Greenhalgh, J., & Roland, M. O. (2016) · Health Services and Delivery Research · doi:10.3310/hsdr04150 · Cited by 47
Multichannel Delivery in Healthcare: The Impact of Telemedicine Centers in Southern India
Delana, K., Deo, S., Ramdas, K., Subburaman, G.-B. B., & Ravilla, T. (2022) · Management Science · doi:10.1287/mnsc.2022.4488 · Cited by 45
The role of tele-medicine in patients with respiratory diseases
Ambrosino, N., & Fracchia, C. (2017) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2017.1383898 · Cited by 48
“services between hospitals and primary care [84].”
Video-based telehealth in Australian primary health care: current use and future potential
Raven, M. K., Butler, C., & Bywood, P. T. (2013) · Australian Journal of Primary Health · doi:10.1071/py13032 · Cited by 45
“The findings and interpretation of the Virtual Outreach Project (Wallace et al. 2004) are more objective than those of Kalucy et al. (2000) and Fielke (2005) regarding the RRMHS, but the fact that the study was conducted in the UK limits its generalisability to Australia somewhat.”
BackgroundEmergent Challenges in Determining Costs for Economic Evaluations
Jacobs, J., & Barnett, P. G. (2016) · PharmacoEconomics · doi:10.1007/s40273-016-0465-1 · Cited by 45
“[60] found that whenever the patient perspective was included, telehealth was found to be cost saving, whereas when the payer perspective alone was considered, the proportion reporting cost savings reduced to half.”
BackgroundJacobs, J., Hu, J., Slightam, C. A., Gregory, A., & Zulman, D. M. (2019) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2019.0179 · Cited by 45
Clay‐Williams, R., Baysari, M. T., Taylor, N. J., Zalitis, D., Georgiou, A., Robinson, M., Braithwaite, J., & Westbrook, J. I. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2514-7 · Cited by 43
Enabling eHealth as a Pathway for Patient Engagement: a Toolkit for Medical Practice
Graffigna, G., Barello, S., Triberti, S., Wiederhold, B. K., Bosio, A. C., & Riva, G. (2014) · Studies in health technology and informatics · doi:10.3233/978-1-61499-401-5-13 · Cited by 44
Wu, J., Kao, H.-Y., & Sambamurthy, V. (2016) · International Journal of Information Management · doi:10.1016/j.ijinfomgt.2016.09.002 · Cited by 51
Synchronous Home-Based Telemedicine for Primary Care: A Review
Lindenfeld, Z., Berry, C. A., Albert, S. L., Massar, R., Shelley, D., Kwok, L., Fennelly, K. M., & Chang, J. E. (2022) · Medical Care Research and Review · doi:10.1177/10775587221093043 · Cited by 44
“…or clinic to connect with a provider, rather than home-based telemedicine, which refers to patients receiving care while located in their own homes (Chuchu et al., 2018; Flodgren et al., 2015; Khan et al., 2015; Laver et al., 2020; Rush et al., 2018; Swalwell et al., 2018; Wade et al., 2010).”
BackgroundInfluentialThe impacts of and outcomes from telehealth delivered in prisons: A systematic review
Tian, E. J., Venugopalan, S., Kumar, S., & Beard, M. (2021) · PLoS ONE · doi:10.1371/journal.pone.0251840 · Cited by 43
“Whereas when telehealth was assessed from the patient perspective, cost savings were commonly identified as a result of savings in patient travel costs [20, 62].”
BackgroundResultInfluentialJiang, B., Bills, M., & Poon, P. (2020) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x20966466 · Cited by 42
Cost analysis of telerehabilitation after arthroscopic subacromial decompression
Pastora‐Bernal, J., Martín‐Valero, R., & Barón-López, F. J. (2017) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17723367 · Cited by 41
“Economic analysis is of central importance to telerehabilitation (TR) because the main rationales for its introduction have been to decrease the cost of delivering healthcare, make more efficient use of the health workforce, and improve timely and equitable access to services.(3) From that perspective, the fundamental…”
BackgroundMethodWade, V., & Stocks, N. P. (2016) · Heart Lung and Circulation · doi:10.1016/j.hlc.2016.10.013 · Cited by 41
Self-citationDesign and Customization of Telemedicine Systems
Martínez-Alcalá, C. I., Muñoz, M., & Fierro, J. M. M. (2013) · Computational and Mathematical Methods in Medicine · doi:10.1155/2013/618025 · Cited by 42
“Thus, companies involved in the health area must expand their capabilities to all stakeholders, including patients and the public in general towards robust, efficient, and friendly telemedicine systems [7, 8].”
BackgroundMashru, J., Kirlew, M., Saginur, R., & Schreiber, Y. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x15625136 · Cited by 39
“Previously published economic analyses question whether telemedicine is indeed cost-effective from the standpoint of the provider.(14) It is generally believed that true monetary gains rely on overall socioeconomic benefits that take patient and physician travel costs and hours of missed work for appointments into acc…”
BackgroundWhat Is Digital Health and What Do I Need to Know About It?
Lowery, C. L. (2020) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2020.02.011 · Cited by 38
Telemedicine uptake among Genetics Professionals in Europe: room for expansion
Otten, E., Birnie, E., Lucassen, A., Ranchor, A. V., & van Langen, I. M. (2015) · European Journal of Human Genetics · doi:10.1038/ejhg.2015.83 · Cited by 37
Stitching Infrastructures to Facilitate Telemedicine for Low-Resource Environments
Chandwani, R. K., & Kumar, N. (2018) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3173574.3173958 · Cited by 40
“Arguably, telemedicine tends to amplify the effectiveness and efficiency of existing healthcare delivery or the lack thereof [45].”
BackgroundRuf, B., Jenkinson, P., Armour, D. L., Fraser, M., & Watson, A. J. M. (2019) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x19849280 · Cited by 37
“Thus, VC clinics can be cost-effective from a healthcare provider’s point of view, especially for rural healthcare.(24) Of note, this distancemanagement solution was not intended to reduce drug costs – for example, for biologic medication.”
BackgroundKoivunen, M. H., Niemi, A., & Hupli, M. (2014) · Journal of Advanced Nursing · doi:10.1111/jan.12529 · Cited by 36
Modes of delivery in preventive intervention studies: a rapid review
Beall, R. F., Baskerville, N. B., Golfam, M., Saeed, S., & Little, J. (2014) · European Journal of Clinical Investigation · doi:10.1111/eci.12279 · Cited by 36
Overcoming Barriers to Larger-Scale Adoption of Telepsychiatry
Mahmoud, H., Vogt, E. L., Sers, M., Fattal, O., & Ballout, S. (2019) · Psychiatric Annals · doi:10.3928/00485713-20181228-02 · Cited by 35
An economic cost analysis of an expanding, multi-state behavioural telehealth intervention
Yilmaz, S., Horn, B. P., Fore, C., & Bonham, C. (2019) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x18774181 · Cited by 26
Connected Mental Health: Systematic Mapping Study
(2020) · doi:10.2196/19950 · Cited by 33
“CMH can use technology-based interventions such as video conferencing; telemental health [26]; mobile-based interventions [27,28]; internet-based solutions [29,30], which are necessary in situations such as global health pandemics; and novel digital data collection interventions [31,32].”
BackgroundHorn, B. P., Barragan, G. N., Fore, C., & Bonham, C. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x15587171 · Cited by 25
Green, S., Hartzfeld, D., Terry, A. B., Fissell, K., Friedman, S. J., Paolino, N., Principe, K., Sandbach, J. F., Trzupek, K. M., Winheld, S., et al. (2022) · Journal of Genetic Counseling · doi:10.1002/jgc4.1627 · Cited by 35
Jeffs, L. P., Jain, A. K., Man, R., Onabajo, N., Desveaux, L., Shaw, J., Hensel, J. M., Agarwal, P., Saragosa, M., Jamieson, T., et al. (2017) · BMC Nephrology · doi:10.1186/s12882-017-0557-y · Cited by 32
“Further, telehomecare can reduce costs associated with improved coordination, continuity of care, and access to specialized care [20, 25, 26].”
Background
Metadata
- Authors
- Wade, V. A., Karnon, J., Elshaug, A. G., & Hiller, J. E.
- Affiliations
- The University of Adelaide (AU)
- South Australia Pathology (AU)
- Corresponding author
- Wade, Victoria A
- Venue
- BMC Health Services Research
- Published
- 2010-08-10
- Volume
- 10
- Issue
- 1
- Pages
- 233-233
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC2927589
- OpenAlex
- W1990461339
- Cited by
- 351
- References
- 68
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 28 · 2023: 16 · 2022: 29 · 2021: 34 · 2020: 31 · 2019: 24 · 2018: 21 · 2017: 25 · 2016: 28 · 2015: 27 · 2014: 19 · 2013: 18 · 2012: 15
- FWCI
- 2.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Research Bank (Australian Catholic University) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- 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 › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Technology
- Keywords
- telemedicine, real-time video communication, synchronous telehealth, cost-effectiveness, health care costs, health outcomes, rural health care, home care, patient travel costs
- MeSH terms
- Costs and Cost Analysis, Humans, Rural Population, Video Recording, Telemedicine
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