Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-18T01:27:49.242Z Has data issue: false hasContentIssue false
  • English
  • Français

COSTS OF HOME-BASED TELEMEDICINE PROGRAMS: A SYSTEMATIC REVIEW

Published online by Cambridge University Press:  30 July 2018

Tzeyu L. Michaud Open the ORCID record for Tzeyu L. Michaud [Opens in a new window] ,
Junmin Zhou ,
Molly A. McCarthy ,
Mohammad Siahpush  and
Dejun Su
Tzeyu L. Michaud
Affiliation:
Center for Reducing Health Disparities, College of Public Health Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USAtzeyu.michaud@unmc.edu
Junmin Zhou
Affiliation:
Department of Health Promotion, Social and Behavioral Health, West China School of Public Health, Sichuan University, Chengdu, China
Molly A. McCarthy
Affiliation:
Department of Occupational Therapy, Creighton University, Omaha, NE, USA
Mohammad Siahpush
Affiliation:
Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
Dejun Su
Affiliation:
Center for Reducing Health Disparities, College of Public Health Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Keywords

TelemedicineCostsHome-basedChronic disease
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 4 , 2018 , pp. 410 - 418
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

References

REFERENCES

1.American Telemedicine Association. What is telemedicine. http://www.americantelemed.org/main/about/telehealth-faqs- (accessed November 20, 2017).Google Scholar
2.Jennett, P, Hall, LA, Hailey, D, et al. The socio-economic impact of telehealth: A systematic review. J Telemed Telecare. 2003;9:311–320.Google Scholar
3.Burgiss, S, Dimmick, S. Telehealth in home health care. Care Manag J. 2003;4:110–116.Google Scholar
4.Chen, H-F, Kalish, MC, Pagan, JA. Telehealth and hospitalizations for Medicare home healthcare patients. Am J Manag Care. 2011;17Spec No.):e224–e230.Google Scholar
5.de Waure, C, Cadeddu, C, Gualano, MR, Ricciardi, W. Telemedicine for the reduction of myocardial infarction mortality: A systematic review and a meta-analysis of published studies. Telemed J E Health. 2012;18:323–328.Google Scholar
6.Polisena, J, Tran, K, Cimon, K, et al. Home telehealth for chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Telemed Telecare. 2010;16:120–127.Google Scholar
7.Polisena, J, Tran, K, Cimon, K, et al. Home telehealth for diabetes management: A systematic review and meta-analysis. Diabetes Obes Metab. 2009;11:913–930.Google Scholar
8.Polisena, J, Tran, K, Cimon, K, et al. Home telemonitoring for congestive heart failure: A systematic review and meta-analysis. J Telemed Telecare. 2010;16:68–76.Google Scholar
9.Louis, AA, Turner, T, Gretton, M, Baksh, A, Cleland, JG. A systematic review of telemonitoring for the management of heart failure. Eur J Heart Fail. 2003;5:583–590.Google Scholar
10.Inglis, SC, Clark, RA, McAlister, FA, Stewart, S, Cleland, JG. Which components of heart failure programmes are effective? A systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review. Eur J Heart Fail. 2011;13:1028–40.Google Scholar
11.Clark, RA, Inglis, SC, McAlister, FA, Cleland, JG, Stewart, S. Telemonitoring or structured telephone support programmes for patients with chronic heart failure: Systematic review and meta-analysis. BMJ. 2007;334:942.Google Scholar
12.Backhaus, A, Agha, Z, Maglione, ML, et al. Videoconferencing psychotherapy: A systematic review. Psychol Serv. 2012;9:111.Google Scholar
13.McGeary, DD, McGeary, CA, Gatchel, RJ. A comprehensive review of telehealth for pain management: Where we are and the way ahead. Pain Pract. 2012;12:570–577.Google Scholar
14.Swanepoel, DW, Hall, JW III. A systematic review of telehealth applications in audiology. Telemed J E Health. 2010;16:181–200.Google Scholar
15.Paré, G, Jaana, M, Sicotte, C. Systematic review of home telemonitoring for chronic diseases: The evidence base. JAMA. 2007;14:269–277.Google Scholar
16.DelliFraine, JL, Dansky, KH. Home-based telehealth: A review and meta-analysis. J Telemed Telecare. 2008;14:62–66.Google Scholar
17.Hersh, WR, Helfand, M, Wallace, J, et al. Clinical outcomes resulting from telemedicine interventions: A systematic review. BMC Med Inform Decis Mak. 2001;1:5.Google Scholar
18.Thokala, P, Baalbaki, H, Brennan, A, et al. Telemonitoring after discharge from hospital with heart failure: Cost-effectiveness modelling of alternative service designs. BMJ Open. 2013;3:e003250.Google Scholar
19.Centers for Medicare and Medicaid Services. Telehealth Services. Telehealth Services. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf (accessed December 29, 2017).Google Scholar
20.Weinstein, RS, Lopez, AM, Joseph, BA, et al. Telemedicine, telehealth, and mobile health applications that work: Opportunities and barriers. Am J Med. 2014;127:183–187.Google Scholar
21.Higgins, JP, Green, S. Cochrane handbook for systematic reviews of interventions. http://training.cochrane.org/handbook (accessed June 13, 2018).Google Scholar
22.Moher, D, Liberati, A, Tetzlaff, J, Altman, DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med. 2009;151:264–269.Google Scholar
23.WHO. Noncommunicable diseases. http://www.who.int/topics/noncommunicable_diseases/en/ (accessed December 13, 2015).Google Scholar
24.Demiris, G. Home based e-health applications. Stud Health Technol Inform. 2004;106:15–24.Google Scholar
25.Dávalos, ME, French, MT, Burdick, AE, Simmons, SC. Economic evaluation of telemedicine: Review of the literature and research guidelines for benefit-cost analysis. Telemed J E Health. 2009;15:933–948.Google Scholar
26.Bureau of labor Statistics. Consumer price index-all urban consumers. https://beta.bls.gov/dataViewer/view/timeseries/CUUR0000SA0 (accessed December 29, 2017).Google Scholar
27.Guyatt, G, Oxman, AD, Akl, EA, et al. GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64:383–394.Google Scholar
28.Fletcher, EC, Stich, J, Yang, KL. Unattended home diagnosis and treatment of obstructive sleep apnea without polysomnography. Arch Fam Med. 2000;9:168.Google Scholar
29.Smith, CE, Cha, JJ, Kleinbeck, SV, et al. Feasibility of in-home telehealth for conducting nursing research. Clin Nurs Res. 2002;11:220–233.Google Scholar
30.Cheung, DS, Heizer, D, Wilson, J, Gage, BF. Cost-savings analysis of using a portable coagulometer for monitoring homebound elderly patients taking warfarin. Am J Geriatr Cardiol. 2003;12:283–287.Google Scholar
31.Walsh, M, Coleman, JR. Developing a pilot telehealth program: One agency's experience. Home Healthc Nurs. 2005;23:188–191.Google Scholar
32.Rabinowitz, T, Murphy, KM, Amour, JL, et al. Benefits of a telepsychiatry consultation service for rural nursing home residents. Telemed J E Health. 2010;16:34–40.Google Scholar
33.Hicks, LL, Fleming, DA, Desaulnier, A. The application of remote monitoring to improve health outcomes to a rural area. Telemed J E Health. 2009;15:664–671.Google Scholar
34.Benatar, D, Bondmass, M, Ghitelman, J, Avitall, B. Outcomes of chronic heart failure. Arch Intern Med. 2003;163:347–352.Google Scholar
35.Noel, HC, Vogel, DC, Erdos, JJ, Cornwall, D, Levin, F. Home telehealth reduces healthcare costs. Telemed J E Health. 2004;10:170–183.Google Scholar
36.Bohnenkamp, SK, McDonald, P, Lopez, AM, Krupinski, E, Blackett, A, editors. Traditional versus telenursing outpatient management of patients with cancer with new ostomies. Oncology nursing forum; 2004. Pittsburgh, PA: Oncology Nursing Society; 2004.Google Scholar
37.Finkelstein, SM, Speedie, SM, Potthoff, S. Home telehealth improves clinical outcomes at lower cost for home healthcare. Telemed J E Health. 2006;12:128–136.Google Scholar
38.Reed, SD, Li, Y, Oddone, EZ, Neary, AM, Orr, MM, Grubber, JM et al. Economic evaluation of home blood pressure monitoring with or without telephonic behavioral self-management in patients with hypertension. Am J Hypertens. 2010;23:142–148.Google Scholar
39.Ruckdäschel, S, Reiher, M, Rohrbacher, R, Nagel, E. The role of health economics in telemedicine. Dis Manag Health Outcomes. 2006;14:3–7.Google Scholar
40.Kennedy, CA. The challenges of economic evaluations of remote technical health interventions. Clin Invest Med. 2005;28:71–74.Google Scholar
41.Adler-Milstein, J, Kvedar, J, Bates, DW. Telehealth among US hospitals: Several factors, including state reimbursement and licensure policies, influence adoption. Health Aff (Millwood). 2014;33:207–215.Google Scholar
42.Seto, E. Cost comparison between telemonitoring and usual care of heart failure: A systematic review. Telemed J E Health. 2008;14:679–686.Google Scholar
43.Gaikwad, R, Warren, J. The role of home-based information and communications technology interventions in chronic disease management: A systematic literature review. Health Inform J. 2009;15:122–146.Google Scholar
44.Kumar, G, Falk, DM, Bonello, RS, et al. The costs of critical care telemedicine programs: A systematic review and analysis. Chest J. 2013;143:19–29.Google Scholar
45.Kidholm, K, Kristensen, MBD. A scoping review of economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management. Appl Health Econ Health Policy. 2018;16:273.Google Scholar
46.Egger, M, Davey-Smith, G, Altman, D. Systematic reviews in health care: Meta-analysis in context. New York: John Wiley & Sons; 2008.Google Scholar
47.Bensink, M, Hailey, D, Wootton, R. A systematic review of successes and failures in home telehealth: Preliminary results. J Telemed Telecare. 2006;12(Suppl 3):8–16.Google Scholar
48.Dansky, KH, Palmer, L, Shea, D, Bowles, KH. Cost analysis of telehomecare. Telemed J E Health. 2001;7:225–232.Google Scholar
Supplementary material: File

Michaud et al. supplementary material

Tables S1-S3

Download Michaud et al. supplementary material(File)
File 33.2 KB