Determinants of the Cost-Effectiveness of Telemedicine: Systematic Screening and Quantitative Analysis of the Literature

被引:10
|
作者
Bell-Aldeghi, Rosalind [1 ,2 ,3 ]
Gibrat, Benjamin [2 ]
Rapp, Thomas [2 ]
Chauvin, Pauline [2 ]
Le Guern, Morgane [1 ]
Billaudeau, Nathalie [1 ]
Ould-Kaci, Karim [1 ]
Sevilla-Dedieu, Christine [1 ]
机构
[1] MGEN Fdn Publ Hlth, Paris, France
[2] Univ Paris Cite, LIRAES EA 4470, Paris, France
[3] MGEN Fdn Publ Hlth, F-75748 Paris, France
关键词
telemedicine; systematic review; economic evaluation; costing; textual analysis;
D O I
10.1089/tmj.2022.0161
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background and Objectives: Telemedicine holds the promise of increasing access-to-care at a lower cost. Yet, for years, the evidence of telemedicine's cost-effectiveness was scarce. Faced with a rapidly expanding literature, we conduct both manual and systematic selection of the literature, and analyzed the data to determine: (1) the characteristics of economic evaluations of telemedicine, and (2) the determinants of economically efficient telemedicine interventions.Methods: We reviewed all published economic evaluations of telemedicine in Cochrane, Embase, and Pubmed from 2008 to 2018. Articles were screened by two researchers first on title and abstract (Stage 1), then on full article (Stage 2), (protocol available on PROSPERO, ref. CRD42019143032). We proposed an alternative method for screening articles using machine learning based on textual classification and compared these two approaches. We constructed an exclusive dataset on the characteristics of the selected articles and enriched it using OECD data at the country level. We identified the determinants of efficient telemedicine interventions using multiple logit models.Results and Conclusion: We included 156 articles out of 2,639. Most economic studies of our sample regard telemonitoring. A majority (73.7%) of studies found that telemedicine intervention is efficient, regardless of the medical domain. Articles with higher standards of economic evaluation (cost-effectiveness analysis, randomized trials with high sample size) were less likely to report an efficient intervention. We found no effect of the publication year, signifying that the nature of the evidence has not changed over time.
引用
收藏
页码:1078 / 1087
页数:10
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