How cost-effective is it for health services to use teleoncology compared with standard oncology care?

From Cancer Guidelines Wiki

Introduction

A review of studies of the economic benefits of various telehealth models revealed no net savings. This review included studies of rural centres with both short and long distances from tertiary centres, many sub-specialities and varying methodologies.[1] However, studies from sites that provide care to rural centres with long travel distances in Kansas, USA and Townsville, Australia, did reveal cost savings to the health systems.[2][3] These studies did not, however, include savings to the patients, so are likely to be an under representation of the true benefits.

In Kansas, the cost of outpatient consultations decreased as the services continued to grow.[2][3] The Townsville study showed significant savings to the health system due to reduction in the travel and accommodation costs for patients, their escorts and specialists. Over 4.5 years, the cost of establishing and running the network was $442,276 AUD and the savings created by preventing patient and escort travel, specialist travel and by reducing aeromedical transfers was $762,394 AUD with the net savings of $320,118 AUD. As the number of patients increased, not surprisingly, the health system savings also increased. Cost neutrality was achieved when 105 patients were consulted. In smaller rural centres where the number of patients is small, sharing of the telehealth equipment by several specialities would improve cost effectiveness.

Similar findings were observed in genetic counselling, management of depression and pain in cancer, head and neck cancer and breast and head and neck multidisciplinary meetings when teleoncology was utilised.[4][5][6][7][8][9]

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Evidence summary and recommendation

Evidence summary Level References
Cost savings have been reported for teleoncology models in various oncology subspecialties and multidisciplinary meetings. II, IV [4], [5], [6], [3], [8]
Evidence-based recommendationQuestion mark transparent.png Grade
Cost savings to the health systems can be achieved through teleoncology models when large travel distances and high patient numbers are involved.
B


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References

  1. Mistry H. Systematic review of studies of the cost-effectiveness of telemedicine and telecare. Changes in the economic evidence over twenty years. J Telemed Telecare 2012 Jan;18(1):1-6 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22101609.
  2. 2.0 2.1 Doolittle GC, Williams AR, Spaulding A, Spaulding RJ, Cook DJ. A cost analysis of a tele-oncology practice in the United States. J Telemed Telecare 2004;10 Suppl 1:27-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15603601.
  3. 3.0 3.1 3.2 Thaker DA, Monypenny R, Olver I, Sabesan S. Cost savings from a telemedicine model of care in northern Queensland, Australia. Med J Aust 2013 Sep 16;199(6):414-7 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24033216.
  4. 4.0 4.1 Buchanan AH, Datta SK, Skinner CS, Hollowell GP, Beresford HF, Freeland T, et al. Randomized Trial of Telegenetics vs. In-Person Cancer Genetic Counseling: Cost, Patient Satisfaction and Attendance. J Genet Couns 2015 Apr 3 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25833335.
  5. 5.0 5.1 Choi Yoo SJ, Nyman JA, Cheville AL, Kroenke K. Cost effectiveness of telecare management for pain and depression in patients with cancer: results from a randomized trial. Gen Hosp Psychiatry 2014 Nov;36(6):599-606 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25130518.
  6. 6.0 6.1 Dorrian C, Ferguson J, Ah-See K, Barr C, Lalla K, van der Pol M, et al. Head and neck cancer assessment by flexible endoscopy and telemedicine. J Telemed Telecare 2009;15(3):118-21 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19364891.
  7. Kunkler IH, Prescott RJ, Lee RJ, Brebner JA, Cairns JA, Fielding RG, et al. TELEMAM: a cluster randomised trial to assess the use of telemedicine in multi-disciplinary breast cancer decision making. Eur J Cancer 2007 Nov;43(17):2506-14 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/17962011.
  8. 8.0 8.1 Stalfors J, Björholt I, Westin T. A cost analysis of participation via personal attendance versus telemedicine at a head and neck oncology multidisciplinary team meeting. J Telemed Telecare 2005;11(4):205-10 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16007751.
  9. Watanabe SM, Fairchild A, Pituskin E, Borgersen P, Hanson J, Fassbender K. Improving access to specialist multidisciplinary palliative care consultation for rural cancer patients by videoconferencing: report of a pilot project. Support Care Cancer 2013 Apr;21(4):1201-7 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23161339.

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Appendices