Center for Reducing Health Disparities,College of Public Health.
Department of Health Promotion, Social and Behavioral Health,West China School of Public Health, Sichuan University,Chengdu,China.
Int J Technol Assess Health Care. 2018 Jan;34(4):410-418. doi: 10.1017/S0266462318000454. Epub 2018 Jul 30.
The aim of this study was to systematically investigate existing literature on the costs of home-based telemedicine programs, and to further summarize how the costs of these telemedicine programs vary by equipment and services provided.
We undertook a systematic review of related literature by searching electronic bibliographic databases and identifying studies published from January 1, 2000, to November 30, 2017. The search was restricted to studies published in English, results from adult patients, and evaluation of home telemedicine programs implemented in the United States. Summarized telemedicine costs per unit of outcome measures were reported.
Twelve studies were eligible for our review. The overall annual cost of providing home-based telemedicine varied substantially depending on specific chronic conditions, ranging from USD1,352 for heart failure to USD206,718 for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and diabetes as a whole. The estimated cost per-patient-visit ranged from USD24 for cancer to USD39 for CHF, COPD, or chronic wound care.
The costs of home-based telemedicine programs varied substantially by program components, disease type, equipment used, and services provided. All the selected studies indicated that home telemedicine programs reduced care costs, although detailed cost data were either incomplete or not presented in detail. A comprehensive analysis of the cost of home-based telemedicine programs and their determinants is still required before the cost efficiency of these programs can be better understood, which becomes crucial for these programs to be more widely adopted and reimbursed.
本研究旨在系统调查现有的家庭远程医疗计划成本文献，并进一步总结这些远程医疗计划的成本如何因所提供的设备和服务而异。
我们通过搜索电子文献数据库，对 2000 年 1 月 1 日至 2017 年 11 月 30 日期间发表的相关文献进行了系统评价。检索范围仅限于发表于英文文献、针对成年患者的研究，以及评估在美国实施的家庭远程医疗计划的研究。报告了按单位产出指标汇总的远程医疗成本。
有 12 项研究符合我们的综述标准。提供家庭远程医疗的年度总成本因具体慢性疾病而异，范围从心力衰竭的 1352 美元到心力衰竭、慢性阻塞性肺疾病和糖尿病的 206718 美元不等。每次患者就诊的估计费用从癌症的 24 美元到心力衰竭、慢性阻塞性肺疾病或慢性伤口护理的 39 美元不等。
家庭远程医疗计划的成本因计划组成部分、疾病类型、使用的设备和提供的服务而异。所有选定的研究都表明家庭远程医疗计划降低了医疗成本，尽管详细的成本数据要么不完整，要么没有详细说明。在更好地了解这些计划的成本效益之前，仍需要对家庭远程医疗计划及其决定因素的成本进行全面分析，这对于这些计划更广泛地采用和报销至关重要。
