RESUMEN
Telemedicine is suffering from pilotitis. Only few initiatives manage to scale up to make significant impact. It is challenging to obtain good indicators for dissemination and use, and it is, therefore, difficult to provide evidence that telemedicine projects fulfil the prophecies of reducing cost, improving quality of care and providing equitable access to health care services. The telemedicine mapping project seeks to provide a national contemporary overview of telemedicine initiatives in Denmark. The project is introduced, challenges in keeping the database behind the map updated are presented and attempts to promote rapid update are discussed.
Asunto(s)
Bases de Datos Factuales , Telemedicina , Dinamarca , Telemedicina/organización & administración , Telemedicina/tendenciasRESUMEN
Table 2, 'Stoddart [19]' row: The cell entry in the 'Mean cost per control patient (SE)' column.
RESUMEN
Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. A scoping review of economic evaluations of home monitoring of patients with chronic disease based on randomised controlled trials and including information on the programme costs and the costs of equipment was carried out based on a Medline (PubMed) search. Nine studies met the inclusion criteria. All studies include both costs of equipment and use of staff, but there is large variation in the types of equipment and types of tasks for the staff included in the costs. Equipment costs constituted 16-73% of the total programme costs. In six of the nine studies, home monitoring resulted in a reduction in primary care or emergency contacts. However, in total, home monitoring resulted in increased average costs per patient in six studies and reduced costs in three of the nine studies. The review is limited by the small number of studies found and the restriction to randomised controlled trials, which can be problematic in this area due to lack of blinding of patients and healthcare professionals and the difficulty of implementing organisational changes in hospital departments for the limited period of a trial. Furthermore, our results may be based on assessments of older telemedicine interventions.