Can economic evaluation in telemedicine be trusted? A systematic review of the literature

被引:60
作者
Bergmo T.S. [1 ]
机构
[1] Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway
关键词
Economic Evaluation; Home Care; Telemedicine Service; Direct Health Care Cost; Full Economic Evaluation;
D O I
10.1186/1478-7547-7-18
中图分类号
学科分类号
摘要
Background: Telemedicine has been advocated as an effective means to provide health care services over a distance. Systematic information on costs and consequences has been called for to support decision-making in this field. This paper provides a review of the quality, validity and generalisability of economic evaluations in telemedicine. Methods: A systematic literature search in all relevant databases was conducted and forms the basis for addressing these issues. Only articles published in peer-reviewed journals and written in English in the period from 1990 to 2007 were analysed. The literature search identified 33 economic evaluations where both costs (resource use) and outcomes (non-resource consequences) were measured. Results: This review shows that economic evaluations in telemedicine are highly diverse in terms of both the study context and the methods applied. The articles covered several medical specialities ranging from cardiology and dermatology to psychiatry. The studies analysed telemedicine in home care, and in primary and secondary care settings using a variety of different technologies including videoconferencing, still-images and monitoring (store-and-forward telemedicine). Most studies used multiple outcome measures and analysed the effects using disaggregated cost-consequence frameworks. Objectives, study design, and choice of comparators were mostly well reported. The majority of the studies lacked information on perspective and costing method, few used general statistics and sensitivity analysis to assess validity, and even fewer used marginal analysis. Conclusion: As this paper demonstrates, the majority of the economic evaluations reviewed were not in accordance with standard evaluation techniques. Further research is needed to explore the reasons for this and to address how economic evaluation in telemedicine best can take advantage of local constraints and at the same time produce valid and generalisable results. © 2009 Bergmo; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 60 条
[1]  
Sibbald B., McDonald R., Roland M., Shifting care from hospitals to the community: a review of the evidence on quality and efficiency, J Health Serv Res Policy, 12, pp. 110-117, (2007)
[2]  
Reardon T., Research findings and strategies for assessing telemedicine costs, Telemed J E Health, 11, pp. 348-369, (2005)
[3]  
Currell R., Urquhart C., Wainwright P., Lewis R., Telemedicine versus face to face patient care: effects on professional practice and health care outcomes, Cochrane Database Syst Rev, (2000)
[4]  
Drummond M., Sculpher M., Common methodological flaws in economic evaluations, Medical Care, 43, pp. 5-14, (2005)
[5]  
Sculpher M.J., Price M., Measuring costs and consequences in economic evaluation in asthma, Respir Med, 97, pp. 508-520, (2003)
[6]  
Sassi F., McKee M., Roberts J.A., Economic evaluation of diagnostic technology. Methodological challenges and viable solutions, Int J Technol Assess Health Care, 13, pp. 613-630, (1997)
[7]  
Drummond M.F., Sculpher M.J., Torrance G.W., O'Brien B.J., Stoddart G.L., Methods for the Economic Evaluation of Health Care Programmes, (2005)
[8]  
Whitten P.S., Mair F.S., Haycox A., May C.R., Williams T.L., Hellmich S., Systematic review of cost effectiveness studies of telemedicine interventions, BMJ, 324, pp. 1434-1437, (2002)
[9]  
Taylor P., Evaluating telemedicine systems and services, J Telemed Telecare, 11, pp. 167-177, (2005)
[10]  
Hakansson S., Gavelin C., What do we really know about the cost-effectiveness of telemedicine?, J Telemed Telecare, 6, SUPPL 1, (2000)