The National Center for Telehealth & Technology and University of Washington School of Medicine, Joint Base Lewis-McChord, WA 98431, USA.
Psychol Serv. 2013 Aug;10(3):276-82. doi: 10.1037/a0030658. Epub 2012 Nov 12.
The economic evaluation of telemental health (TMH) is necessary to inform ways to decrease the cost of delivering care, to improve access to care, and to make decisions about the allocation of resources. Previous reviews of telehealth economic analysis studies have concluded that there are significant methodological deficiencies and inconsistencies that limit the ability to make generalized conclusions about the costs and benefits of telehealth programs. Published economic evaluations specific to TMH are also limited. There are unique factors that influence costs in TMH that are necessary for those who are planning and evaluating economic analyses to consider. The purpose of this review is to summarize the main problems and limitations of published economic analyses, to discuss considerations specific to TMH, and to inform and encourage the economic evaluation of TMH in both the public and private sectors. The topics presented here include perspective of costs, direct and indirect costs, and technology, as well as research methodology considerations. The integration of economic analyses into effectiveness trials, the standardization of outcome measurement, and the development of TMH economic evaluation guidelines are recommended.
精神科远程医疗的经济评估对于降低医疗服务成本、改善医疗服务可及性以及资源配置决策至关重要。之前对远程医疗经济分析研究的综述得出结论，存在显著的方法学缺陷和不一致性，限制了对远程医疗项目的成本和效益做出普遍结论的能力。专门针对精神科远程医疗的已发表经济评估也很有限。在规划和评估经济分析时，需要考虑影响精神科远程医疗成本的独特因素。本综述的目的是总结已发表的经济分析中的主要问题和局限性，讨论精神科远程医疗的具体考虑因素，并为公共和私营部门的精神科远程医疗经济评估提供信息和鼓励。这里介绍的主题包括成本视角、直接和间接成本以及技术，以及研究方法学的考虑因素。建议将经济分析纳入疗效试验、规范结果测量以及制定精神科远程医疗经济评估指南。
