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This research received no specific grant from any funding agency, commercial or not-for-profit sectors.
The American Telemedicine Association defines telemedicine (or telehealth) as the use of medical information exchanged from one site to another by means of electronic communications and to improve patient clinical health status (1). Over the past 2 decades, telemedicine has been increasingly used in disease control and management, and is associated with benefits such as increased access to health services, cost-effectiveness, more educational opportunities, improved health outcomes, better quality of care, and enhanced social support for patients (2). For example, telemedicine allows for better quality of care by constantly monitoring patients’ vital conditions, and provides for more efficient use of resources by reducing travel time for health professionals and patients (3).
Studies have also shown that telemedicine service provided in patients’ homes or community clinics improved health outcomes through prompt consultation, guidance, and needed services, and in turn reduced the risk of hospitalization and emergency department use (4). Furthermore, consummate findings based on meta-analyses conducted to evaluate the effectiveness of telemedicine across various disease types, such as myocardial infarction (5), chronic obstructive pulmonary disease (6), diabetes (7), heart failure (8–11), mental health (12), pain management (13), and audiology (14) suggested the feasibility and prospect of using telemedicine to achieve better outcomes and/or reduced healthcare costs.
Although various review studies have documented the effectiveness of telemedicine in facilitating home-based disease control and management compared with usual care (15–18), few have assessed program costs. An important reason is that program cost has rarely been reported in published studies on telemedicine. Because by far third-party payers (e.g., Medicare, or private insurers) do not cover or subsidize the initial infrastructure costs of telemedicine or reimburse most services (19;20), program costs can be prohibiting for many telemedicine programs to be initiated or sustained.
In this study, we seek to examine the cost of home-based telemedicine services through a systematic review of the relevant literature. The primary objectives of this study were to: (i) understand the cost structure and components of home telemedicine based on a systematic review of studies with a documentation of program costs; and (ii) summarize home telemedicine costs either on an annual or per-patient-visit basis.
METHODS
Data Sources and Literature Search
To identify...