OBJECTIVES

: There has been a rapid uptake of telehealth in primary care during the coronavirus (COVID-19) pandemic; the challenge now is ensuring that telehealth will be sustainable post-pandemic. One key requirement for service sustainability is confirming economic viability. To achieve this, we conducted a systematic review to examine the cost-effectiveness of telehealth in primary care.

METHODS

: A systematic literature search was conducted to identify articles that conducted economic evaluations of telehealth services in primary care settings. Searches of PubMed, EMBASE, Scopus and CINAHL databases were undertaken using keywords relating to telehealth, primary care, and economic or cost. Title, abstract and full-text reviews were conducted and data extraction of study characteristics, economic analysis, and description of service models was performed. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to evaluate study reporting quality.

RESULTS

: Twenty articles were selected for final inclusion. Four studies employed six analysis types through a cost-consequence analysis, cost-utility analysis, and cost-effectiveness analysis. Five studies used a cost-minimisation analysis and eleven used a simple cost analysis. Telehealth service models included triage services, substitution services, other services, and new services. There was a widespread of reporting quality when studies were assessed again the CHEERS checklist. Most studies reported telehealth as cost-effective, although the quality of this evidence is dependent on study context, analysis type and service model delivered.

CONCLUSIONS

: In various circumstances, telehealth services in primary care are cost-effective. Services appear to be cost-effective when used in appropriate clinical scenarios, when clinician time efficiency is improved, and when overall health service utilisation is reduced. However, telehealth implementation should be motivated by potential overall benefits rather than cost reduction alone. Telehealth can facilitate multidisciplinary care and expand primary care services. Decision makers need to consider the societal benefits of telehealth implementation, as well as the economic benefits.