Format

Send to

Choose Destination
See comment in PubMed Commons below
Am J Geriatr Psychiatry. 2014 Mar;22(3):253-62. doi: 10.1016/j.jagp.2013.01.058. Epub 2013 Jun 4.

Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a health economic modeling study.

Author information

1
Trimbos Institute (The Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Clinical Psychology, VU University, Amsterdam, The Netherlands. Electronic address: jlokkerbol@trimbos.nl.
2
Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
3
University of Pittsburgh, School of Medicine, Pittsburgh, PA.
4
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.
5
European Science Foundation, Strasbourg, France.
6
Trimbos Institute (The Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.

Abstract

OBJECTIVES:

Depressive disorders are significant causes of disease burden and are associated with substantial economic costs. It is therefore important to design a healthcare system that can effectively manage depression at sustainable costs. This article computes the benefit-to-cost ratio of the current Dutch healthcare system for depression, and investigates whether offering more online preventive interventions improves the cost-effectiveness overall.

METHODS:

A health economic (Markov) model was used to synthesize clinical and economic evidence and to compute population-level costs and effects of interventions. The model compared a base case scenario without preventive telemedicine and alternative scenarios with preventive telemedicine. The central outcome was the benefit-to-cost ratio, also known as return-on-investment (ROI).

RESULTS:

In terms of ROI, a healthcare system with preventive telemedicine for depressive disorders offers better value for money than a healthcare system without Internet-based prevention. Overall, the ROI increases from €1.45 ($1.72) in the base case scenario to €1.76 ($2.09) in the alternative scenario in which preventive telemedicine is offered. In a scenario in which the costs of offering preventive telemedicine are balanced by reducing the expenditures for curative interventions, ROI increases to €1.77 ($2.10), while keeping the healthcare budget constant.

CONCLUSIONS:

For a healthcare system for depressive disorders to remain economically sustainable, its cost-benefit ratio needs to be improved. Offering preventive telemedicine at a large scale is likely to introduce such an improvement.

KEYWORDS:

Cost-benefit analysis; depressive disorder; e-health; health economic modeling; prevention

PMID:
23759290
PMCID:
PMC4096928
DOI:
10.1016/j.jagp.2013.01.058
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center