Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, U.S.A.
Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.
Laryngoscope. 2021 Aug;131(8):1741-1748. doi: 10.1002/lary.29321. Epub 2020 Dec 23.
OBJECTIVE/HYPOTHESIS: The COVID-19 pandemic has resulted in telehealth becoming commonplace in many health care fields. Telehealth benefits include improving access, decreasing costs, and elevating patient's experience. A review of cost minimization (CM) analyses was performed in order to explore scientific studies associated with integrating tele-otolaryngology in clinical practice. Our primary objective was to evaluate published literature for cost related to the implementation of telemedicine across otolaryngology, and to determine CM when compared to in-person visits.
Systematic Literature Review.
We performed a systematic review using PubMed, EMBASE, and Cochrane in May 2020, to identify studies with a cost analysis of tele-otolaryngology care. Inclusion criteria focused on articles citing CM data from telehealth services. Literature quality was assessed using the MINORS scoring system.
From 380 original articles screened only nine evaluated cost in otolaryngology. CM in the US ranged from $68 to $900 per visit. Cost was evaluated in general otolaryngology, sleep medicine, otology, and head and neck cancer surgery, the latter had the most benefit. The most common types of telehealth visits were routine follow-up and screening. Data were insufficient for meta-analysis.
Telemedicine has been trialed across various otolaryngology subspecialties; its incorporation is projected to have a meaningful impact on access to specialty care. This research suggests that the delivery of virtual care reduces cost with the potential of increasing net revenue across multiple otolaryngology subspecialties. Further studies are needed to better discern the entirety of cost savings and the best settings for integration.
3 Laryngoscope, 131:1741-1748, 2021.
目的/假设：COVID-19 大流行导致远程医疗在许多医疗保健领域变得普遍。远程医疗的好处包括改善可及性、降低成本和提升患者体验。我们进行了一项成本最小化（CM）分析的综述，以探讨与将远程耳鼻喉科整合到临床实践相关的科学研究。我们的主要目的是评估已发表的文献中与耳鼻喉科中实施远程医疗相关的成本，并确定与面对面就诊相比的 CM。
系统文献综述。
我们于 2020 年 5 月使用 PubMed、EMBASE 和 Cochrane 进行了系统综述，以确定对远程耳鼻喉科护理进行成本分析的研究。纳入标准集中在引用远程医疗服务 CM 数据的文章上。使用 MINORS 评分系统评估文献质量。
从 380 篇原始文章中筛选出的只有 9 篇评估了耳鼻喉科的成本。美国的 CM 范围为每次就诊 68 至 900 美元。在普通耳鼻喉科、睡眠医学、耳科和头颈部癌症手术中进行了 CM 评估，后者获益最大。最常见的远程医疗就诊类型是常规随访和筛查。数据不足，无法进行荟萃分析。
远程医疗已在各种耳鼻喉科亚专业中进行了试验；预计其引入将对获得专业护理产生重大影响。这项研究表明，虚拟护理的提供可降低成本，并有可能在多个耳鼻喉科亚专业中增加净收益。需要进一步的研究来更好地了解全部成本节约和最佳整合环境。
3 级 Laryngoscope, 131:1741-1748, 2021.
