Abstract：
INTRODUCTION:Using real-world data from the Providence Oregon Telestroke Network, we examined the cost-effectiveness of telestroke from both the spoke and hub perspectives by level of financial responsibility for these costs and by patient stroke severity. METHODS:We constructed a decision analytic model using patient-level clinical and financial data from before and after telestroke implementation. Effectiveness was measured as quality-adjusted life years (QALYs) and was combined with cost per patient outcomes to calculate incremental cost effectiveness ratios (ICERs). Outcomes were generated (a) overall; (b) by stroke severity, via the National Institute of Health Stroke Scale (NIHSS) at time of arrival, defined as low (<5), medium (5-14) and high (>15); and (c) by percentage of implementation costs paid by spokes (0%, 50%, 100%). RESULTS:Data for 864 patients, 98 pre- and 766 post-implementation, were used to parameterize our model. From the spoke perspective, telestroke had ICERs of US$1322/QALY, US$25,991/QALY and US$50,687/QALY when responsible for 0%, 50%, and 100% of these costs, respectively. Overall, the ICER ranged from US$22,363/QALY to US$71,703/QALY from the hub perspective. CONCLUSIONS:Our results support previous models showing good value, overall. However, costs and ICERs varied by stroke severity, with telestroke being most cost-effective for severe strokes. Telestroke was least cost effective for the spokes if spokes paid for more than half of implementation costs.
journal_name
J Telemed Telecarejournal_title
Journal of telemedicine and telecareauthors
Nelson RE,Okon N,Lesko AC,Majersik JJ,Bhatt A,Baraban Edoi
10.1177/1357633X15613920subject
Has Abstractpub_date
2016-10-01 00:00:00pages
413-21issue
7eissn
1357-633Xissn
1758-1109pii
1357633X15613920journal_volume
22pub_type
杂志文章abstract：:We evaluated the diagnostic accuracy of slit-lamp photographs interpreted by telemedicine compared to a conventional clinical examination. A convenience sample of 21 patients with anterior segment disease was enrolled at the Lumbini Eye Institute (LEI) in Bhairahawa, Nepal. An ophthalmologist at the LEI examined each ...
journal_title：Journal of telemedicine and telecare
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abstract：:We assessed the effectiveness of two methods of patient education, a printed manual and a Website, provided to patients waiting for cardiac surgery. The four-phase study was conducted over two and a half years, and included urban and rural subjects in Vancouver and the interior of British Columbia. The Website was bas...
journal_title：Journal of telemedicine and telecare
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abstract：:A telemedicine service was established for the Scottish Police College with medical advice provided from the Aberdeen Royal Infirmary. Use of the service from November 2004 to February 2006 was audited. A total of 192 patients presented to the service during the 16-month study period. There were 97 teleconsultations. ...
journal_title：Journal of telemedicine and telecare
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abstract：:In 2003, the Institute of Tropical Medicine (ITM) in Antwerp set up an Internet-based decision support service to assist health-care workers in the management of difficult HIV/AIDS cases. This service is available to physicians working in resource-limited settings. Between April 2003 and December 2009, the telemedicin...
journal_title：Journal of telemedicine and telecare
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abstract：:We conducted a randomized controlled study to compare conventional lectures with tele-education for delivering wound care education. Education was delivered by the two methods simultaneously to two classes. Forty-eight paramedics received a live didactic presentation and 41 paramedics received the same lecture via vid...
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更新日期：2012-03-01 00:00:00
abstract：:In March 1998 two neurologists and a professor of telemedicine met to solve a clinical problem--how to get neurological expertise to patients admitted acutely to hospitals which had no resident neurologist. Four years later, two new consultant neurologists were appointed in Northern Ireland with sessions in telemedici...
journal_title：Journal of telemedicine and telecare
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更新日期：2002-01-01 00:00:00
abstract：:Introduction Pulmonary rehabilitation (PR) is an integral part of the management of chronic obstructive pulmonary disease (COPD). However, many patients do not access or complete PR, and long-term exercise maintenance has been difficult to achieve after PR. This study aimed to investigate feasibility, long-term exerci...
journal_title：Journal of telemedicine and telecare
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abstract：:We compared the costs and cost-effectiveness of telemonitoring vs usual care for patients with chronic obstructive pulmonary disease (COPD). A total of 256 patients were randomised to either telemonitoring or usual care. In the telemonitoring arm, the touch-screen telemonitoring equipment transmitted data to clinical ...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章,随机对照试验
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更新日期：2015-03-01 00:00:00
abstract：:Telemedicine and new media (e.g. the Internet, tele-teaching and tele-learning) are increasingly being used in medicine. We surveyed the awareness and acceptance of these developments on the part of medical students (n =750) at the University of Innsbruck. A 16-item questionnaire was handed out in randomly chosen medi...
journal_title：Journal of telemedicine and telecare
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journal_title：Journal of telemedicine and telecare
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abstract：:We conducted a pilot study of the effectiveness of individual counselling sessions provided by a dietician through telemedicine for patients with diabetes. All participants received a single group education session via videoconference. Those who were randomized to the intervention also received two additional follow-u...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章,随机对照试验
doi：10.1258/jtt.2008.080813
更新日期：2009-01-01 00:00:00
abstract：:We evaluated the effect of a video-phone network on peer support among frail elderly people living at home. We conducted a one-year trial of network formation among 14 people (five men and nine women, age range 78-85 years) through coordinator intervention and the use of ISDN video-phones. The purpose of the intervent...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章,多中心研究
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更新日期：2003-01-01 00:00:00
abstract：:We studied the feasibility, acceptability and cost-effectiveness of using telemedicine to provide geriatric services to residents of nursing homes. A local 200-bed nursing home supported by the community geriatric assessment team (CGAT) participated in a one-year study, during which videoconferencing was used to repla...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章
doi：10.1258/13576330260440808
更新日期：2002-12-01 00:00:00
abstract：:Early telemedicine networks employed dedicated telecommunications circuits (e.g. leased digital lines) in which the sender and receiver were connected by a private circuit. More recently, the Internet has become widely available for general use, including telemedicine. The Internet was engineered to permit network pat...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章,评审
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更新日期：2005-01-01 00:00:00
abstract：:We developed an interactive mobile-phone based application, SmartDiet, that analyzes daily nutrition intake and patterns of daily exercise. It provides a personalized diet profile and promotes knowledge about nutrition using a diet game. We evaluated the effectiveness of the SmartDiet application in terms of acquiring...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章
doi：10.1258/jtt.2010.090913
更新日期：2010-01-01 00:00:00
abstract：:The teleambulance aims to facilitate adequate medical treatment by initiating and guaranteeing maximum preparation and immediate hospital handling of the patient either at the scene of an incident or during transportation. Following the problem definition and the identification of the medical fields the technology can...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章
doi：10.1258/1357633961929367
更新日期：1996-01-01 00:00:00
abstract：:It has been suggested that joint teleconsultations can improve communication at the primary-secondary care interface. We examined data from a qualitative analysis of social interactions in teleconsultations between specialists and general practitioners. The primary interaction was between specialists and patients. The...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章
doi：10.1258/135763306777978425
更新日期：2006-01-01 00:00:00
abstract：:We studied self-observations related to weight management recorded with a Wellness Diary application on a mobile phone. The data were recorded by 27 participants in a 12-week study, which included a short weight management lecture followed by independent usage of the Wellness Diary. We studied the validity of self-obs...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章
doi：10.1258/jtt.2009.091103
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:Rehabilitation approaches for people with rheumatoid arthritis include joint protection, exercises and self-management strategies. Health interventions delivered via the web have the potential to improve access to health services overcoming time constraints, physical limitations, and socioeconomic and geogra...
journal_title：Journal of telemedicine and telecare
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abstract：:Eighty-four dermatologists in private practice in Bavaria were surveyed by postal questionnaire. Of the 45 who responded (a 54% response rate), 96% used a computer in their private practice. Fifty-seven per cent of respondents owned systems with Pentium processors, while 23% were still using 386 or 486 processors. Mos...
journal_title：Journal of telemedicine and telecare
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abstract：BACKGROUND:In France, a specially-designed care plan for the elderly is generally based on an interdisciplinary, complex and time-consuming process. The health system assigns care throughout the social and health care services using multiple providers and sites. OBJECTIVE:The free website www.jesuisautonome.fr offers ...
journal_title：Journal of telemedicine and telecare
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更新日期：2015-07-01 00:00:00
abstract：:Business model and financial recovery issues dominate discussions about using telemedicine to improve chronic disease management. The technical issues are numerous, daunting and complex, but many can be addressed using the resources and infrastructure available in large, well-integrated clinical information systems. T...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章
doi：10.1258/135763306778393126
更新日期：2006-01-01 00:00:00
abstract：:Tele-education has been used for many years to deliver continuing education programmes to rural health-care professionals. The main modes are audio, video and computer. Audio technologies involve the transmission of the spoken word (voice) between learners and instructors, either synchronously or asynchronously. Examp...
journal_title：Journal of telemedicine and telecare
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更新日期：2006-01-01 00:00:00
abstract：INTRODUCTION:Telepharmacy has the potential to enhance pharmacy services in oncology care, especially in remote areas. This scoping review explored the range, critical benefits and barriers of using telepharmacy services in oncology care. METHODS:The scoping review followed the Arksey and O'Malley's five-stage framewo...
journal_title：Journal of telemedicine and telecare
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更新日期：2020-12-30 00:00:00
abstract：:Prison inmates were surveyed about their perceptions of the use of videoconferencing in clinical consultations. A 14-item questionnaire was used to assess satisfaction with the patient-physician clinical interaction. Of the 299 inmates surveyed immediately after their teleconsultations, 221 completed questionnaires th...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章
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更新日期：1999-01-01 00:00:00
abstract：:This research was conducted to evaluate the efficacy of an online speech perception test (SPT) for the measurement of hearing and hearing aid fitting in comparison with conventional methods. Phase 1 was performed with 88 people to evaluate the SPT for the detection of significant hearing loss. The SPT had high sensiti...
journal_title：Journal of telemedicine and telecare
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doi：10.1177/1357633X15611568
更新日期：2015-12-01 00:00:00
abstract：:Objective We evaluated the impact of telemedicine-delivered behaviour activation treatment (BAT) on glycemic control in a subgroup of older adults with diabetes who participated in a randomized controlled trial for depression. Research design and methods We randomized older adults with major depression to same-room or...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章,随机对照试验
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更新日期：2018-10-01 00:00:00
abstract：:Introduction We have conducted a feasibility study on remote autopsy services in order to increase the flexibility of the service with benefits for teaching and interdepartmental collaboration. Methods Three senior staff pathologists, one senior autopsy technician and one junior resident participated in the study. Nin...
journal_title：Journal of telemedicine and telecare
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更新日期：2018-08-01 00:00:00
abstract：:We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervent...
journal_title：Journal of telemedicine and telecare
pub_type： 杂志文章,多中心研究,随机对照试验
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更新日期：2008-01-01 00:00:00
abstract：INTRODUCTION:Much attention has been focused on decreasing chronic obstructive pulmonary disease (COPD) hospital readmissions. The US health system has struggled to meet this goal. The objective of this study was to assess the efficacy of telehealth services on the reduction of hospital readmission and mortality rates ...
journal_title：Journal of telemedicine and telecare
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doi：10.1177/1357633X20970402
更新日期：2020-11-11 00:00:00
