title: Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.
abstract: OBJECTIVE
  A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented.
  
  
  METHODS
  Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date.
  
  
  RESULTS
  The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems.
  
  
  CONCLUSIONS
  There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.
authors.affiliation: 1 Department of Signal Theory and Communications, and Telematics Engineering, University of Valladolid , Valladolid, Spain .
authors.forename: Isabel
authors.initials: I
authors.lastname: de la Torre-Díez
authors.forename: Miguel
authors.initials: M
authors.lastname: López-Coronado
authors.forename: Cesar
authors.initials: C
authors.lastname: Vaca
authors.forename: Jesús Saez
authors.initials: JS
authors.lastname: Aguado
authors.forename: Carlos
authors.initials: C
authors.lastname: de Castro
mesh_terms: D003362:Cost-Benefit Analysis; D057286:Electronic Health Records / Q000191:economics*; D006801:Humans; D017216:Telemedicine / Q000191:economics* / Q000379:methods / Q000458:organization & administration
keywords: business administration/economics; e-health; mobile health; telemedicine