International Journal of Technology Assessment in Health Care

General Essays

Home telehealth for chronic disease management: A systematic review and an analysis of economic evaluations

Julie Polisenaa1, Doug Coylea2, Kathryn Coylea3 and Sarah McGilla4

a1 Canadian Agency for Drugs and Technologies in Health (CADTH)

a2 University of Ottawa

a3 Coyle Consultancy

a4 Canadian Agency for Drugs and Technologies in Health (CADTH)

Abstract

Objectives: The research objectives were two-fold: first, to systematically review the literature on the cost-effectiveness of home telehealth for chronic diseases, and second to develop a framework for the conduct of economic evaluation of home telehealth projects for patients with chronic diseases.

Methods: A comprehensive literature search identified twenty-two studies (n = 4,871 patients) on home telehealth for chronic diseases published between 1998 and 2008. Studies were reviewed in terms of their methodological quality and their conclusions.

Results: Home telehealth was found to be cost saving from the healthcare system and insurance provider perspectives in all but two studies, but the quality of the studies was generally low. An evaluative framework was developed which provides a basis to improve the quality of future studies to facilitate improved healthcare decision making, and an application of the framework is illustrated using data from an existing program evaluation of a home telehealth program.

Conclusions: Current evidence suggests that home telehealth has the potential to reduce costs, but its impact from a societal perspective remains uncertain until higher quality studies become available.

Footnotes

We are grateful to Khai Tran, Karen Cimon, Eike-Henner W. Kluge, Hussein Noorani, Krisan Palmer, and Richard Scott for their contribution to the project. Conflict of interest: None declared. This project was funded by the Canadian Agency for Drugs and Technologies in Health (CADTH).