Cost-effectiveness of telehealth interventions for chronic heart failure patients: a literature review.
OBJECTIVE
Evidence exists that telehealth interventions (e.g., telemonitoring, telediagnostics, telephone care) in disease management for chronic heart failure patients can improve medical outcomes, and we aim to give an overview of the cost-effectiveness of these interventions.


METHODS
Based on the literature search on "heart failure" in combination with "cost" and "telehealth" we selected 301 titles and abstracts. Titles and abstracts were screened for a set of inclusion criteria: telehealth intervention, heart failure as the main disease, economic analysis present and a primary study performed. In the end, thirty-two studies were included for full reading, data extraction, and critical appraisal of the economic evaluation.


RESULTS
Most studies did not present a comprehensive economic evaluation, consisting of the comparison of both costs and effects between telehealth intervention and a comparator. Data on telehealth investment costs were lacking in many studies. The few studies that assessed costs and consequences comprehensively showed that telehealth interventions are cost saving with slight improvement in effectiveness, or comparably effective with similar cost to usual care. However, the methodological quality of the studies was in general considered to be low.


CONCLUSIONS
The cost-effectiveness of telehealth in chronic heart failure is hardly ascertained in peer reviewed literature, the quality of evidence is poor and there was a difficulty in capturing all of the consequences/effects of telehealth intervention. We believe that without full economic analyses the cost-effectiveness of telehealth interventions in chronic heart failure remains unknown.
Institute of Health Policy and Management, Erasmus University Rotterdam Care Management Solutions, Philips Research.
Andrija S
AS
Grustam
Institute of Health Policy and Management, Erasmus University Rotterdam.
Johan L
JL
Severens
Centre for Information Services, Philips Research.
Jan
J
van Nijnatten
Care Management Solutions, Philips Research.
Ron
R
Koymans
Saw Swee Hock School of Public Health, National University of Singapore.
Hubertus J M
HJM
Vrijhoef
D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D019468:Disease Management; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D017216:Telemedicine / Q000191:economics*