Systematic review of cost effectiveness studies of telemedicine interventions
Systematic review of cost effectiveness studies of telemedicine interventions
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DOI：
10.1136/bmj.324.7351.1434
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发表时间：
2002-06-15
影响因子：
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通讯作者：
Hellmich, S
中科院分区：
文献类型：
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作者：
Whitten, PS;Mair, FS;Hellmich, S
目的系统回顾远程医疗的成本效益研究，设计系统回顾英文同行评议期刊文章，数据来源Medline、Embase、ISI引文索引，和远程医疗信息交换数据库。研究选择了612篇识别文章中的55篇，这些文章提供了实际的成本效益数据。主要结果措施通过使用既定的裁决工具评估报告的科学质量。结果557篇无成本数据的文章按主题分类。55篇文章的数据最初按研究中使用的成本变量和结论进行分类。只有24/55（44%）的研究符合质量标准，证明纳入质量审查。20/24（83%）仅限于简单的成本比较。没有研究使用成本效用分析，这是建立治疗干预所代表的“物有所值”的传统方法。只有7/24（29%）的研究试图探讨远程医疗服务与传统组织的医疗保健相比所需的利用水平。没有解决这个问题，在足够的细节，以充分回答it.15/24（62.5%）的文章在这里回顾没有提供任何细节的敏感性分析，所有的经济分析方法应incorporation.Conclusion T这里是没有很好的证据表明，远程医疗是一种具有成本效益的手段提供医疗保健。
Objectives To systematically review cost benefit studies of telemedicine.Design Systematic review of English language, peer reviewed journal articles.Data sources Searches of Medline, Embase, ISI citation indexes, and database of Telemedicine Information Exchange.Studies selected 55 of 612 identified articles that presented actual cost benefit data.Main outcome measures Scientific quality of reports assessed by use of an established instrument for adjudicating on the quality of economic analyses.Results 557 articles without cost data categorised by topic. 55 articles with data initially categorised by cost variables employed in the study and conclusions. Only 24/55 (44%) studies met quality criteria justifying inclusion in a quality review. 20/24 (83%) restricted to simple cost comparisons. No study used cost utility analysis, the conventional means of establishing the "value for money" that a therapeutic intervention represents. Only 7/24 (29%) studies attempted to explore the level of utilisation that would be needed for telemedicine services to compare favourably with traditionally organised health care. None addressed this question in sufficient detail to adequately answer it. 15/24 (62.5%) of articles reviewed here provided no details of sensitivity analysis, a method all economic analyses should incorporate.Conclusion T here is no good evidence that telemedicine is a cost effective means of delivering health care.