Cost-effectiveness of personalised telehealth intervention for chronic disease management: A pilot randomised controlled trial

PLoS One. 2023 Jun 15;18(6):e0286533. doi: 10.1371/journal.pone.0286533. eCollection 2023.

Abstract

Objective: The study aims to assess the cost-effectiveness of a personalised telehealth intervention to manage chronic disease in the long run.

Method: The Personalised Health Care (PHC) pilot study was a randomised trial with an economic evaluation alongside over 12 months. From a health service perspective, the primary analysis compared the costs and effectiveness of PHC telehealth monitoring with usual care. An incremental cost-effectiveness ratio was calculated based on costs and health-related quality of life. The PHC intervention was implemented in the Barwon Health region, Geelong, Australia, for patients with a diagnosis of COPD and/or diabetes who had a high likelihood of hospital readmission over 12 months.

Results: When compared to usual care at 12 months, the PHC intervention cost AUD$714 extra per patient (95%CI -4879; 6308) with a significant improvement of 0.09 in health-related quality of life (95%CI: 0.05; 0.14). The probability of PHC being cost-effective by 12 months was close to 65%, at willingness to pay a threshold of AUD$50,000 per quality-adjusted life year.

Conclusion: Benefits of PHC to patients and the health system at 12 months translated to a gain in quality-adjusted life years with a non-significant cost difference between the intervention and control groups. Given the relatively high set-up costs of the PHC intervention, the program may need to be offered to a larger population to achieve cost-effectiveness. Long-term follow-up is required to assess the real health and economic benefits over time.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Delivery of Health Care
  • Humans
  • Pilot Projects
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Telemedicine*

Grants and funding

The Victorian Government provided funding for the pilot project, with an in-kind contribution by Barwon Health. The funder (Victorian government) had no role in study design, data collection or analysis, or decision to publish. Barwon Health (in-kind contribution) had a role in study design, data collection and analysis, and the decision to publish.