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BMC Health Services Research

, 10:233

First Online: 10 August 2010Received: 02 May 2010Accepted: 10 August 2010DOI: 10.1186-1472-6963-10-233

Cite this article as: Wade, V.A., Karnon, J., Elshaug, A.G. et al. BMC Health Serv Res 2010 10: 233. doi:10.1186-1472-6963-10-233

Abstract

BackgroundTelehealth 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.

MethodsA 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.

Results36 articles met the inclusion criteria. 2261% of the studies found telehealth to be less costly than the non-telehealth alternative, 1131% 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, 26% 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.

ConclusionDelivery 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.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-10-233 contains supplementary material, which is available to authorized users.

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Autor: Victoria A Wade - Jonathan Karnon - Adam G Elshaug - Janet E Hiller

Fuente: https://link.springer.com/







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