An economic evaluation of Japanese telemedicine, focusing on teleradiology and telepathology.

We collected information by postal survey from 622 medical institutions reported to be using telemedicine in Japan. The questionnaire asked about willingness to pay (WTP) for telemedicine and willingness to undertake (WTU) it. The Kernel Estimation Method was used to obtain WTP for teleradiology (4379 yen), telepathology (9526 yen), teleconferencing (2084 yen) and teleconsultation (633 yen). The estimated WTU were teleradiology (3875 yen), telepathology (17,918 yen), teleconferencing (3230 yen) and teleconsultation (3643 yen). These values are larger than the current charges that customers actually pay or providers receive. Multiplying these values by the number of medical institutions that had implemented telemedicine allows the total annual benefits of telemedicine to be estimated, e.g. for teleradiology, the annual benefit in terms of WTP and WTU (millions of yen per year) were 140.20 and 1101.75, respectively. Based on the results of the survey, specific policy measures to promote telemedicine further include improvement of quality and reimbursement.

On the evaluation of economic benefits of Japanese telemedicine and factors for its promotion.

This paper attempts to estimate economic values of telemedicine and to extract factors that promote telemedicine through the use of survey data. This is the first analysis aimed at evaluating telemedicine in Japan. We utilized the Contingent Valuation Method and estimated demand functions of telemedicine. Because the number of institutions replying with willingness to pay (WTP) and willingness to undertake (WTU) is relatively small, the Kernel Estimation Method was applied. After estimating WTP and WTU, by multiplying the number of medical institutions currently implementing telemedicine, the whole value in Japan was obtained. By using the Tobit Model, factors that influence WTP and WTU were extracted. Estimated WTP was 35.23 dollars for teleradiology and 162.89 dollars for telepathology. WTU estimated was 39.81 dollars for teleradiology and 86.59 dollars for telepathology. Estimated economic benefits in Japan for 1 year were 1.27 million dollars for WTP of teleradiology and 278,600 dollars for telepathology. WTU is 10 million dollars for teleradiology and 393,400 dollars for telepathology. Medical institutions with the following characteristics tend to reply larger WTP: (1) university hospitals, (2) internal medicine, (3) radiology, and (4) use of video conference systems. Regarding WTU, the following characteristics influence WTU: (1) use of a personal computer, (2) use of telepathology equipment, (3) high satisfaction with the quality of telemedicine, and (4) experience base of telemedicine. Based on the nationwide survey on telemedicine, the total value of telemedicine in Japan was estimated. In addition to the evaluation, quantitative aspects of implementation of telemedicine, such as factors to promote telemedicine, are analyzed. These can provide useful information for further implementation of telemedicine not only in Japan but in other countries as well.

An empirical analysis of a telehealth system in terms of cost-sharing.

We interviewed 348 users of a home telemonitoring system and asked questions about their willingness to pay (WTP). Assuming that the functional form of demand was logistic, the best estimate of the WTP was yen 4519 per user per month. We also analysed how the benefits of the system (expressed in terms of WTP) were attributed to four factors: stabilizing illness; enhancement of health consciousness; less anxiety in day-to-day life; and a decrease in medical expenditures. All except the last were significant. According to the resulting model, individual users should bear yen 2763 in costs, while society should reimburse yen 349. Surprisingly, the value of yen 2763 obtained here is very close to the amount ( yen 2500) actually charged by Kamaishi City.

[Home-medical-care and IT--for the further diffusion of the tele-health system].

In this study, we examined the economic benefit of the tele-health system based on a field survey performed in Kamaishi City in Iwate Prefecture, Nishiaizu Town and Katsurao Village in Fukushima Prefecture, and Sangawa Town in Kagawa Prefecture. The economic benefit analyzed here was based upon willingness to pay (WTP). The cost items of the system included those of initial introduction and maintenance; the former included costs of equipment and software, whereas the latter the salaries of staff and others. We compared the benefit to cost ratio (B/C ratio) among these cases. We also discussed measures to further expand the tele-health system.