Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy.
Department of Neurosciences and Reproductive and Odontostomatological Sciences and University "Federico II" of Naples, Naples, Italy.
Telemed J E Health. 2024 Feb;30(2):404-414. doi: 10.1089/tmj.2023.0106. Epub 2023 Jul 19.
Telemedicine has proven successful in relieving the burden of chronic neurological disorders from the national health care systems by ensuring a highly customized and effective management plan. Although many studies focus on assessing telemedicine effectiveness, little is known about the economic implications of telemedicine applications in chronic neurological diseases (CNDs). This issue could account for a lack of widespread implementation. Our study attempted to fill this gap by systematically reviewing scientific literature on the economic evaluation of telemedicine compared with traditional care in the management of CNDs. We performed a literature search on PubMed, Google Scholar, Scopus, Embase, and Medline. The inclusion criteria were as follows: (1) studies with a full cost-analysis; (2) randomized controlled trials; (3) studies comparing telemedicine interventions with traditional care; (4) articles focusing only on CNDs. Conversely, the exclusion criteria were as follows: (1) studies focusing on acute neurological conditions or other diseases and (2) study protocols, case report, duplicate articles, abstract only, books, letters to editors, and review articles. Ten articles met the inclusion criteria. Three different approaches of telemedicine intervention could be identified: digital cognitive-behavioral therapy (CBT), motor telerehabilitation, and home monitoring and assessment devices. Cost-analysis showed an overall benefit in terms of both cost and effectiveness from the application of telemedicine instead of in-presence management in CNDs. Among the identified interventions, digital CBT proved to be the most cost-saving. However, promising results were also found in monitoring and assessment devices and in telerehabilitation. Definitely, however, more thorough, comprehensive, and high-quality economic evaluation studies are needed.
远程医疗已被证明通过确保高度定制化和有效的管理计划，成功缓解了国家医疗保健系统中慢性神经障碍的负担。尽管许多研究都集中在评估远程医疗的有效性上，但对于远程医疗在慢性神经疾病（CND）中的应用的经济影响知之甚少。这可能是导致其广泛应用不足的原因。
我们的研究试图通过系统地综述关于远程医疗与传统护理在 CND 管理中的经济评估的科学文献来填补这一空白。我们在 PubMed、Google Scholar、Scopus、Embase 和 Medline 上进行了文献检索。纳入标准如下：（1）具有完整成本分析的研究；（2）随机对照试验；（3）比较远程医疗干预与传统护理的研究；（4）仅关注 CND 的文章。相反，排除标准如下：（1）关注急性神经疾病或其他疾病的研究；（2）研究方案、病例报告、重复文章、仅摘要、书籍、给编辑的信件和评论文章。
有 10 篇文章符合纳入标准。可以确定三种不同的远程医疗干预方法：数字认知行为疗法（CBT）、远程运动康复和家庭监测与评估设备。成本分析表明，在 CND 中应用远程医疗而不是现场管理在成本和效果方面均具有总体优势。在所确定的干预措施中，数字 CBT 被证明是最节省成本的。但是，在监测和评估设备以及远程康复方面也取得了有前景的结果。然而，确实需要进行更彻底、全面和高质量的经济评估研究。
