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COST-EFFECTIVENESS OF TELEHEALTH INTERVENTIONS FOR CHRONIC HEART FAILURE PATIENTS: A LITERATURE REVIEW

Published online by Cambridge University Press:  04 February 2014

Andrija S. Grustam
Affiliation:
Institute of Health Policy and Management, Erasmus University Rotterdam Care Management Solutions, Philips Research
Johan L. Severens
Affiliation:
Institute of Health Policy and Management, Erasmus University Rotterdam
Jan van Nijnatten
Affiliation:
Centre for Information Services, Philips Research
Ron Koymans
Affiliation:
Care Management Solutions, Philips Research
Hubertus J. M. Vrijhoef
Affiliation:
Saw Swee Hock School of Public Health, National University of Singapore

Abstract

Objectives: Evidence exists that telehealth interventions (e.g., telemonitoring, telediagnostics, telephone care) in disease management for chronic heart failure patients can improve medical outcomes, and we aim to give an overview of the cost-effectiveness of these interventions.

Methods: Based on the literature search on “heart failure” in combination with “cost” and “telehealth” we selected 301 titles and abstracts. Titles and abstracts were screened for a set of inclusion criteria: telehealth intervention, heart failure as the main disease, economic analysis present and a primary study performed. In the end, thirty-two studies were included for full reading, data extraction, and critical appraisal of the economic evaluation.

Results: Most studies did not present a comprehensive economic evaluation, consisting of the comparison of both costs and effects between telehealth intervention and a comparator. Data on telehealth investment costs were lacking in many studies. The few studies that assessed costs and consequences comprehensively showed that telehealth interventions are cost saving with slight improvement in effectiveness, or comparably effective with similar cost to usual care. However, the methodological quality of the studies was in general considered to be low.

Conclusions: The cost-effectiveness of telehealth in chronic heart failure is hardly ascertained in peer reviewed literature, the quality of evidence is poor and there was a difficulty in capturing all of the consequences/effects of telehealth intervention. We believe that without full economic analyses the cost-effectiveness of telehealth interventions in chronic heart failure remains unknown.

Type
Assessments
Copyright
Copyright © Cambridge University Press 2014 

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