Economic evaluations of eHealth technologies: A systematic review

Abstract

Background: Innovations in eHealth technologies have the potential to help older adults live independently, maintain their quality of life, and to reduce their health system dependency and health care expenditure. The objective of this study was to systematically review and appraise the quality of cost-effectiveness or utility studies assessing eHealth technologies in study populations involving older adults.

Methods: We systematically searched multiple databases (MEDLINE, EMBASE, CINAHL, NHS EED, and PsycINFO) for peer-reviewed studies published in English from 2000 to 2016 that examined cost-effectiveness (or utility) of eHealth technologies. The reporting quality of included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards statement.

Results: Eleven full text articles met the inclusion criteria representing public and private health care systems. eHealth technologies evaluated by these studies includes computerized decision support system, a web-based physical activity intervention, internet-delivered cognitive behavioral therapy, telecare, and telehealth. Overall, the reporting quality of the studies included in the review was varied. Most studies demonstrated efficacy and cost-effectiveness of an intervention using a randomized control trial and statistical modeling, respectively. This review found limited information on the feasibility of adopting these technologies based on economic and organizational factors.

Conclusions: This review identified few economic evaluations of eHealth technologies that included older adults. The quality of the current evidence is limited and further research is warranted to clearly demonstrate the long-term cost-effectiveness of eHealth technologies from the health care system and societal perspectives.

Fig 1. Study selection and identification flowchart.

Fig 2. CHEERS statement quality results.

Items: (1) Title, (2) Abstract, (3) Background and Objectives, (4) Target population and subgroups, (5) Setting and Location, (6) Study perspective, (7) Comparators, (8) Time horizon, (9) Discount rate, (10) Choice of health outcomes, (11) Effectiveness, (12) Preference valuation, (13) Estimate resources and costs, (14) Currency, price date, conversion, (15) Choice of model, (16) Assumptions, (17) Analytical methods, (18) Study parameters, (19) Incremental costs and outcomes, (20) Uncertainty—single study or model based, (21) Heterogeneity, (22) Study findings/limitations/generalizability/current knowledge, (23) Source of funding, (24) Conflict of interest.