Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway.
J Telemed Telecare. 2010;16(5):229-31. doi: 10.1258/jtt.2010.009008. Epub 2010 May 25.
It has been reported that economic evaluations of telemedicine are less adherent to methodological standards than economic evaluations in other fields. Systematic reviews also show that most studies evaluate benefits in terms of the cost savings, with no assessment of the health benefits for patients. In a recent review of economic evaluations, I found 33 articles that measured both costs and non-resource consequences of using telemedicine in direct patient care. This represents a considerable increase compared to previous reviews. The articles analysed were highly diverse in both study context and applied methods. Most studies used multiple outcome measures, such as diagnostic accuracy, blood glucose levels, wound size or quality-adjusted life-years gained. The effectiveness measures appeared more consistent and well reported than the costings. Objectives, study design and choice of comparators were mostly well reported. However, most studies lacked information on perspective and costing method, few used general statistics and sensitivity analysis to assess validity, and even fewer used marginal analysis. These shortcomings in economic evaluation methodology are relatively common and have been found in other fields of research.
据报道，与其他领域的经济评估相比，远程医疗的经济评估不太符合方法学标准。系统评价也表明，大多数研究都是从成本节约的角度评估效益，而没有评估对患者的健康效益。在最近对经济评估的一项综述中，我发现了 33 篇文章，这些文章评估了直接患者护理中使用远程医疗的成本和非资源后果。这与之前的综述相比有了相当大的增加。分析的文章在研究背景和应用方法上都非常多样化。大多数研究使用了多种结果测量指标，如诊断准确性、血糖水平、伤口大小或获得的质量调整生命年。有效性测量指标比成本指标更一致和报告得更好。目标、研究设计和比较器的选择大多都有很好的报告。然而，大多数研究缺乏关于观点和成本核算方法的信息，很少有研究使用一般统计和敏感性分析来评估有效性，更少的研究使用边际分析。这些经济评估方法学中的缺陷比较常见，在其他研究领域也有发现。
