Cost-effectiveness of Shared Telemedicine Appointments in Young Adults With T1D: CoYoT1 Trial

BackgroundDigital health interventions have significant potential to improve safety, efficacy, and quality of care, reducing waste in healthcare costs. Despite these premises, the evidence regarding cost and effectiveness of digital tools in health is scarce and limited.ObjectivesThe aim of this systematic review is to summarize the evidence on the cost-effectiveness of digital health interventions and to assess whether the studies meet the established quality criteria.MethodsWe queried PubMed, Scopus and Web of Science databases for articles in English published from January 1, 2016 to December 31, 2020 that performed economic evaluations of digital health technologies. The methodological rigorousness of studies was assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2009 checklist.ResultsSearch identified 1,476 results, 552 of which were selected for abstract and 35 were included in this review. The studies were heterogeneous by country (mostly conducted in upper and upper-middle income countries), type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of six different types of interventions: (1) seventeen studies on new video-monitoring service systems; (2) five studies on text messaging interventions; (3) five studies on web platforms and digital health portals; (4) two studies on telephone support; (5) three studies on new mobile phone-based systems and applications; and (6) three studies on digital technologies and innovations.ConclusionFindings on cost-effectiveness of digital interventions showed a growing body of evidence and suggested a generally favorable effect in terms of costs and health outcomes. However, due to the heterogeneity across study methods, the comparison between interventions still remains difficult. Further research based on a standardized approach is needed in order to methodically analyze incremental cost-effectiveness ratios, costs, and health benefits.

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“…- Video-conferencing system: 17/35, 48.6% ( 7 , 9 , 10 , 16 – 20 , 28 – 31 , 33 , 34 , 36 , 37 , 41 ).…”

Section: Resultsmentioning

confidence: 99%

The cost-effectiveness of digital health interventions: A systematic review of the literature

Gentili

Failla

Melnyk

et al. 2022

Front. Public Health

148

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“…For this report, 1 study was identified that examined the societal cost-effectiveness of telehealth for transition-age young adults (18 to 25 years) in Colorado who were living with type 1 diabetes. 47 In this study, a routine diabetes virtual clinic appointment using videoconferencing software was compared with a face-to-face appointment with a diabetes care provider. 47 All patients participated in a group appointment facilitated by a certified diabetes educator.…”

Section: Cost-effectivenessmentioning

confidence: 99%

“…47 In this study, a routine diabetes virtual clinic appointment using videoconferencing software was compared with a face-to-face appointment with a diabetes care provider. 47 All patients participated in a group appointment facilitated by a certified diabetes educator. Quality-adjusted life-years did not differ significantly between the virtual visits group and the face-to-face visits group.…”

Section: Cost-effectivenessmentioning

confidence: 99%

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An Overview of Direct-to-Patient Virtual Visits in Canada

Gray¹,

Mason²,

Loshak³

2021

cjht

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Direct-to-patient virtual visits are a way of providing health care to patients in their location of choice, using technology (e.g., phone, text messaging, video conferencing). The use of virtual visits has the potential to overcome many of the barriers associated with in-person care, including improved access, convenience, and cost savings. Many communities that are underserved by in-person care also face barriers to virtual care. There is a risk that current health inequities will be exacerbated if barriers such as, for example, reliable access to an internet-connected device, technology literacy, and language barriers are not addressed. Virtual visits have been used safely and effectively for many types of health care visits. There is a lack of evidence on the cost-effectiveness of virtual visits. Regulations regarding the provision of virtual visits are needed to uphold equitable access to publicly funded health care as mandated by the Canada Health Act.

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“…Telehealth has been used to successfully deliver pediatric diabetes care (1)(2)(3) and is generally well accepted by patients and caregivers (4)(5)(6). Much like other centers worldwide (7)(8)(9)(10)(11), Stanford Children's Health rapidly expanded telehealth capacity during the coronavirus disease 2019 (COVID-19) pandemic.…”

mentioning

confidence: 99%

Closing Disparities in Pediatric Diabetes Telehealth Care: Lessons From Telehealth Necessity During the COVID-19 Pandemic

et al. 2022

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The coronavirus disease 2019 (COVID-19) pandemic necessitated using telehealth to bridge the clinical gap, but could increase health disparities. This article reports on a chart review of diabetes telehealth visits occurring before COVID-19, during shelter-in-place orders, and during the reopening period. Visits for children with public insurance and for those who were non-English speaking were identified. Telehealth visits for children with public insurance increased from 26.2% before COVID-19% to 37.3% during shelter-in-place and 34.3% during reopening. Telehealth visits for children who were non-English speaking increased from 3.5% before COVID-19% to 17.5% during shelter-in-place order and remained at 15.0% during reopening. Pandemic-related telehealth expansion included optimization of workflows to include patients with public insurance and those who did not speak English. Increased participation by those groups persisted during the reopening phase, indicating that prioritizing inclusive telehealth workflows can reduce disparities in access to care.

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Cost-effectiveness of Shared Telemedicine Appointments in Young Adults With T1D: CoYoT1 Trial

Cited by 16 publications

References 16 publications

The cost-effectiveness of digital health interventions: A systematic review of the literature

The cost-effectiveness of digital health interventions: A systematic review of the literature

An Overview of Direct-to-Patient Virtual Visits in Canada

Closing Disparities in Pediatric Diabetes Telehealth Care: Lessons From Telehealth Necessity During the COVID-19 Pandemic

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