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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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Successful Models for Telehealth
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Edirippulige, S., Smith, A. C., Wickramasinghe, S. I., & Armfield, N. R. (2018) · Journal of Medical Systems · doi:10.1007/s10916-018-1084-5 · Cited by 15
Natafgi, N., Mohr, N. M., Wittrock, A., Bell, A. L., & Ward, M. M. (2019) · The Journal of Rural Health · doi:10.1111/jrh.12370 · Cited by 15
Best, P., McConnell, T., Davidson, G., Badham, J., & Neill, R. D. (2019) · Research Involvement and Engagement · doi:10.1186/s40900-019-0173-z · Cited by 18
Rezapour, A., Jebeli, S. S. H., & Faradonbeh, S. B. (2021) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_787_20 · Cited by 15
“So far, studies have been conducted on the economic evaluation of telemedicine technologies in general[14,15] and not specifically in the care of the older people.”
BackgroundPractical aspects of telehealth: set‐up and preparation for video consultations
Allen, D. T., Caldwell, P. H. Y., Komesaroff, P. A., Loh, P. K., Mozer, R., Sabesan, S. S., Shaheen, N., Talman, P. S., Williams, M. J. S., & Grabinski, O. (2013) · Internal Medicine Journal · doi:10.1111/imj.12264 · Cited by 15
Practical aspects of telehealth: financial considerations
Loh, P. K., Sabesan, S. S., Allen, D. T., Caldwell, P. H. Y., Mozer, R., Komesaroff, P. A., Talman, P. S., Williams, M. J. S., Shaheen, N., Grabinski, O., et al. (2013) · Internal Medicine Journal · doi:10.1111/imj.12193 · Cited by 15
Review of Systematic Reviews in the Field of Telemedicine
Goharinejad, S., Hajesmaeel-Gohari, S., Jannati, N., Goharinejad, S., & Bahaadinbeigy, K. (2021) · Medical Journal of The Islamic Republic of Iran · doi:10.47176/mjiri.35.184 · Cited by 18
Why telehealth does not always save money for the health system
Snoswell, C. L., Taylor, M. L., & Caffery, L. J. (2021) · Journal of Health Organization and Management · doi:10.1108/jhom-04-2020-0159 · Cited by 17
Fatehi, F., Gray, L., & Russell, A. W. (2013) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2013.0213 · Cited by 14
Macnab, I., Rojjanasrirat, W., & Sanders, A. (2012) · Journal of Human Lactation · doi:10.1177/0890334412460512 · Cited by 14
Youm, S., & Park, S.-H. (2015) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2014.0092 · Cited by 14
“Wade et al.(18) conducted systemic analysis of the economic feasibility of u-healthcare.”
BackgroundIdris, H., Nugraheni, W. P., Rachmawati, T., Kusnali, A., Yulianti, A., Purwatiningsih, Y., Nuraini, S., Susianti, N., Faisal, D. R., Arifin, H., et al. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21010090 · Cited by 15
“Telehealth can potentially reform and transform the industry by reducing costs and improving quality, access, and patient satisfaction [25,26].”
BackgroundTelepsychiatry in Australia: A Scoping Review
Woon, L. S., Maguire, P. A., Reay, R. E., & Looi, J. C. (2024) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580241237116 · Cited by 16
The Effect of Telehealth on Cost of Health Care During the COVID-19 Pandemic: A Systematic Review
Lavin, L., Gibbs, H., Vakkalanka, J., Ternes, S., Healy, H. S., Merchant, K., Ward, M. M., & Mohr, N. (2024) · Telemedicine journal and e-health · doi:10.1089/tmj.2024.0369 · Cited by 16
“36 Our review allowed for a comparison across clinical conditions and telehealth applications.”
Caffery, L. J., Taylor, M. L., Lucas, K. R., & Smith, A. C. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x16672767 · Cited by 12
“There are some circumstances where telehealth also reduces costs from the perspective of the health care provider.(20,22) Economic analyses consistently report that the savings attributable to telehealth are greater as the number of consultations (telehealth activity) increases.”
BackgroundPhysicians’ satisfaction with telehealth services among family physicians in Cluster 1 hospitals
Alqahtani, S. S., Alraqi, A., & Alageel, A. (2022) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_920_22 · Cited by 13
The Economics of Telehealth: An Overview
Gujral, K., Illarmo, S., Jacobs, J., & Wagner, T. H. (2025) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2025.0073 · Cited by 16
“92”
Acceptability and Comfort Regarding Remotely Delivered PrEP Services in Mississippi
Giorlando, K. K., Arnold, T. L., Barnett, A. P., Leigland, A., Whiteley, L., Brock, J. B., & Brown, L. K. (2023) · Journal of the International Association of Providers of AIDS Care (JIAPAC) · doi:10.1177/23259582231186868 · Cited by 12
“clients with negative results often leave CBOs without learning about, or being linked to, PrEP care because of inadequate resources and training.(5,6,15) Evidence indicates that remote healthcare services such as telemedicine, HIV self-testing (HIVST), and prescription mail delivery are feasible for rural and resourc…”
BackgroundDoctor-patient interaction in telemedicine: Logic of choice and logic of care perspectives
Chandwani, R. K., & Dé, R. (2016) · Information Systems Frontiers · doi:10.1007/s10796-016-9643-0 · Cited by 12
“While IT for health initiatives have potential to enhance the effectiveness and efficiency of the healthcare systems, a significant number of such initiatives fail to deliver optimum results (Wade et al. 2010; Dwivedi et al. 2015a).”
BackgroundGarcia, R., Adelakun, O., & Han, W. (2017) · Hawaii International Conference on System Sciences (HICSS) · doi:10.24251/hicss.2017.459 · Cited by 14
“Telemedicine services are generally provided either through real time video conferencing, store and forward methods, or hybrid approaches [26].”
BackgroundLovo, S., Harrison, E., O’Connell, M. E., Rotter, T., & Bath, B. L. (2022) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x221098904 · Cited by 12
“37 To the best of our knowledge, there are no cost analyses for PT involvement in an interprofessional care model using videoconferencing.”
BackgroundPeeters, J. M., Mistiaen, P., & Francke, A. L. (2011) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2011.110405 · Cited by 12
A Scenario-Based Study of Doctors and Patients on Video Conferencing Appointments from Home
Han, D., Heshmat, Y., Geiskkovitch, D. Y., Tan, Z., & Neustaedter, C. (2022) · ACM Transactions on Computer-Human Interaction · doi:10.1145/3514234 · Cited by 14
Dawson, J., Howell, M., Howard, K., Campbell, K. L., Craig, J. C., Tong, A., & Lee, V. W. (2021) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12937 · Cited by 10
Cloud Horizons: Strengthening Rural Healthcare Through Telemedicine’s Digital Canopy
Kitole, F. A., & Shukla, S. (2024) · Health Services Insights · doi:10.1177/11786329241284401 · Cited by 10
“39 This technology not only enhances immediate health outcomes but also contributes to broader public health goals by improving continuity of care and reducing the need for costly emergency services.”
BackgroundRykkje, L., & Hjorth, G. H. B. (2017) · SAGE Open · doi:10.1177/2158244017744900 · Cited by 10
“According to Wade et al. (2010), telehealth studies tend to report high patient satisfaction, and such results may be biased, due to the study participants’ desirability and acceptance.”
BackgroundInfluentialHiring Expert Consultants in E-Healthcare: An Analytics-Based Two Sided Matching Approach
Singh, V. K., Mukhopadhyay, S., Xhafa, F., Sharma, A., & Roy, A. (2018) · Lecture notes in computer science · doi:10.1007/978-3-319-99810-7_9 · Cited by 10
“Interesting situation of taking expert consultancy from outside of the in-house medical unit during some censorious medical scenario (mainly surgical process) was taken care by [11, 12, 13, 14, 15].”
BackgroundThinking Outside the Box: Are We Ready for Teleprecepting to Expand Training and Practice Venues?
Johnson, D. S. (2018) · Issues in Mental Health Nursing · doi:10.1080/01612840.2018.1488903 · Cited by 10
“(46%) endorsing cost savings, 17 (49%) reporting higher cost, 1 (3%) indicating costs reduced over time, and 1 (3%) reporting costs to be the same (Wade et al., 2010).”
BackgroundInfluentialCharacterization of User-Centered Security in Telehealth Services
Vega-Barbas, M., Seoane, F., & Pau, I. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16050693 · Cited by 9
Aygün, N. (2020) · SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital · doi:10.14744/semb.2020.65902 · Cited by 10
“It is associated with improvements in attaining care and operational efficiency.[93, 94] However, before implementing the telemedicine program, issues regarding patient privacy, financial reimbursement and technological platforms’ reliability should be considered.”
BackgroundTelehealth and hospital performance: Does it matter?
Zhao, M., Hamadi, H. Y., Xu, J., Haley, D. R., Park, S., & Williams, C. (2020) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x20932440 · Cited by 11
“Other studies found that certain types of telehealth technology, such as video communication that encourages the co-ordination of care, can increase efficiency and lower the cost of care.(43) Hospitals that are investing in telehealth services, including just-in-time services, may be using the technology to replace le…”
BackgroundInitiatives to integrate primary and acute health care, including ambulatory care services
Bywood, P. T., Jackson-Bowers, E., & Muecke, S. (2011) · Flinders Academic Commons (Flinders University) · Cited by 9
Hemberg, J. A. V., & Fischer, R. S. (2018) · Holistic Nursing Practice · doi:10.1097/hnp.0000000000000254 · Cited by 9
In-Person Versus Video Preoperative Visit: A Randomized Clinical Trial
Braxton, E. G., Myers, E. M., Zhao, J. J., Evans, S., & Tarr, M. E. (2022) · Urogynecology · doi:10.1097/spv.0000000000001259 · Cited by 9
“Previous studies have demonstrated that telehealth visits decrease time away from work and subsequent economic losses for patients.(18) Our results are congruent with these previously published findings.”
ResultJohns, G., Whistance, B., Khalil, S. D. S., Whistance, M., Thomas, B., Ogonovsky, M., & Ahuja, A. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-057874 · Cited by 9
Gamus, A., & Chodick, G. (2019) · Advances in Wound Care · doi:10.1089/wound.2018.0906 · Cited by 9
“However, the results were inconsistent.(8,9) Studies of TM, compared to the standard face-to-face care (FTF), have demonstrated equal or nonsignificant differences in clinical outcomes between the two treatment methods.”
ResultAn Overview of Reviews on Telemedicine and Telehealth in Dementia Care: Mixed Methods Synthesis
do Nascimento, I. J. B., Abdulazeem, H. M., Weerasekara, I., Sharifan, A., Bianco, V. G., Kularathne, I., Cunningham, C., Sathian, B., Deeken, G., Østengaard, L., et al. (2025) · JMIR Mental Health · doi:10.2196/75266 · Cited by 9
“…use of remote interventions in dementia care, the development of robust cost-effectiveness studies and frameworks is still required, providing relevant insights for health care policy makers involved in advocating sustainable health care strategies across multiple regions in the globe [152-155].”
Telehealth Adoption and Discontinuation by US Hospitals: Results From 2 Quasi-Natural Experiments
Baird, A. M., Cheng, Y., & Xia, Y. (2022) · JMIR Formative Research · doi:10.2196/28979 · Cited by 8
“Although a number of studies have evaluated the impacts of telehealth on outcomes [2,6-10], such studies have primarily focused on either the determinants of telehealth adoption [11] or effects of telehealth primarily for patient populations limited to specific hospital systems or regions [4,12-14].”
BackgroundThe quality of economic studies of cancer pharmacogenomics: a quantitative appraisal of the evidence
Yang, M., Patil, D. S., Tufail, W., & Issa, A. M. (2013) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.2013.838023 · Cited by 8
Telehealth Use among Community Health Centers and Cardio-Metabolic Health Outcomes
Baidwan, N. K., Davlyatov, G. K., & Mehta, T. S. (2020) · Healthcare · doi:10.3390/healthcare8020165 · Cited by 8
“On the contrary, another review noted that health outcomes in a large proportion of the studies did not significantly improve with provision of such services, although it did prove to be cost effective from a societal perspective [26].”
BackgroundWinward, S., Patel, T., Al-Saffar, M., & Noble, M. (2021) · Journal of Medical Internet Research · doi:10.2196/24917 · Cited by 12
Matulich, M. C., Hou, M. Y., Chen, M. J., Uhm, S., & Creinin, M. D. (2022) · Contraception · doi:10.1016/j.contraception.2022.06.001 · Cited by 8
“Telemedicine provides medical consultations with outcomes comparable to in-person treatment for a variety of specialties and is beneficial for perioperative care [3–5] .”
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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