Addressing cost and time barriers in chronic disease management through telemedicine: an exploratory research in select low- and middle-income countries

Abstract

Background: Despite evidence supporting telehealth provision in developed countries, there is limited evidence regarding its economic benefits for patients living in areas where access and cost present major barriers to health care, particularly in low- and middle-income countries (LMICs). This study explores the economic benefits of telemedicine for patients, in terms of cost and times savings, and its potential role in improving chronic disease outcomes. Methods: This retrospective cross-sectional study compared telemedicine services with hypothetical in-person consultations, with a focus on patient travel time and travel cost savings. A database containing teleconsultation visits ( N = 25,182) conducted at health facilities in remote regions of Afghanistan, Pakistan, Tajikistan, and the Kyrgyz Republic, was analyzed. A two-sample homoscedastic t test was used to determine differences between the two groups. A one-way sensitivity analysis was also conducted, presuming in-person teleconsultations at 90%, 75%, and 50%. Results: The study extracted data from 25,182 teleconsultation visits (12,814 males; 12,368 females). The cumulative patient savings through the program amounted to USD 9,175,132, and 1,876,146 h, or 213.1 years. A significant difference was seen between the two groups in terms of mean time savings ( p-value <0.05), and a nearly significant difference was observed in terms of mean cost savings ( p-value = 0.05). Conclusions: This study suggests that considerable economic benefits imparted to patients in low-resource settings of LMICs via accessing telemedicine. Telemedicine has great potential to improve chronic disease outcomes in low-resource areas by reducing socioeconomic barriers related to cost and access, and increasing uptake of services, thereby enabling early intervention and long-term management.

Telemedicine as the New Outpatient Clinic Gone Digital: Position Paper From the Pandemic Health System REsilience PROGRAM (REPROGRAM) International Consortium (Part 2)

“…Temporary government funding will be necessary to roll out telemedicine to both rural and urban settings, as well as relaxations to legislation that allow practitioner reimbursement of telemedicine services (101). A study by Sayani et al, addressing the cost and time barriers in chronic disease management through telemedicine in LMICs, found telemedicine to be economically beneficial not only by reducing the socioeconomic barriers to cost and access but also by increasing the uptake of services (102). Another systematic review of studies conducted on costs of home-based telemedicine programs from 2000 to 2017 found that home telemedicine programs reduced care costs, although detailed cost data were either incomplete or not presented in detail (103).…”

Internet-based patient– primary care physician–cardiologist integrated management model of hypertension in China: study protocol for a multicentre randomised controlled trial

“…In addition to these benefits, telemedicine can provide considerable economic benefits. 37 Data from 25 182 teleconsultation visits suggest that a total of US$9 175 132, and 1 876 146 hours (213.1 years) in chronic disease management have been saved with the use of telemedicine in low-income and middle-income countries.…”

The Recent Progress and Applications of Digital Technologies in Healthcare: A Review

“…It includes the availability of open information on the health, treatment, complications, and biomedical research in the Internet. On the other hand, the diagnostic and medical consulting services are becoming more accessible and available even in low-income countries [2,3]. Telemedicine provides an opportunity for people from rural and remote regions to get high-quality consulting and advice, while online pharmacy platforms allow obtaining the necessary drugs without unnecessary commuting [4,5].…”