Polisena Julie, Coyle Doug, Coyle Kathryn, McGill Sarah
Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada.
Int J Technol Assess Health Care. 2009 Jul;25(3):339-49. doi: 10.1017/S0266462309990201.
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.
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.
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.
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.
本研究有两个目标：其一，系统回顾关于慢性病家庭远程医疗成本效益的文献；其二，为慢性病患者家庭远程医疗项目的经济评估制定一个框架。
通过全面的文献检索，确定了1998年至2008年间发表的22项关于慢性病家庭远程医疗的研究（n = 4871名患者）。从方法学质量和研究结论方面对这些研究进行了综述。
除两项研究外，从医疗保健系统和保险提供者的角度来看，家庭远程医疗在其他所有研究中均被发现具有成本节约效益，但研究质量普遍较低。开发了一个评估框架，为提高未来研究质量以促进更好的医疗决策提供了基础，并使用来自现有家庭远程医疗项目评估的数据说明了该框架的应用。
目前的证据表明，家庭远程医疗有降低成本的潜力，但在获得更高质量的研究之前，从社会角度来看其影响仍不确定。
