Renal Disease: System Outcomes


The economic effects of home telehealth can be discussed using direct or indirect measures of costs and cost savings.  Direct measures include figures such as cost per patient, cost per telehealth unit, and annual costs.  Examples of indirect measures are probability of patient hospitalization, number of emergency room visits, and other types of health service use.  Though a formal economic analysis would typically assign these services a fixed dollar value, other study designs often report changes in service use without attempting to translate these changes into costs or cost savings.

There is no substantive information on the effects of home telehealth on costs or use of emergency services, specialist appointments, primary care use, or hospitalizations, although estimates provided in 1 study of a teleconsultation system found marginally higher costs in the intervention group.  We retrieved 1 additional article that examines the practical aspects of incorporating home-based telehealth into follow-up care for dialysis patients. As this study was retrieved in a final scan of 2011-2012 literature and was not subject to the same level of analysis as the other studies included in this review, we refer the reader to Chanliau et al. (2012) for more details.



While outcomes are reported in both Gallar et al. (2007) and Michael et al. (2009), the quality of the evidence is not sufficient to support conclusions at this time. Readers are advised to exercise caution when interpreting the findings described below.

Emergency Services Use

Emergency services use was not reported in any studies.


 (Re-) Hospitalizations

Summary: (Re-) hospitalizations were reported in 2 studies, both of which suffered from serious limitations. Findings suggest that home telehealth may have the potential to reduce hospitalizations, but the evidence is insufficient to support conclusions at this time.

Study Details: Gallar et al. (2007) reported a significant difference in mean hospitalization rate: 2.2 days per patient per year in the intervention group vs. 5.7 days per patient per year in the control group (p<.05).

One hospitalization occurred during the 3-month study by Michael et al. (2009), which was equal to the number occurring in the 3 months previous.


Primary Care Use

Primary care use was not reported in any studies.


Specialist Care Use

Specialist care use was not reported in any studies.


Telehealth Costs and Cost Comparisons

Summary: One study reported on telehealth costs and cost comparisons. Evidence on the effects of home telehealth is insufficient.

Study Details: Gallar et al. (2007) estimates the cost of teleconsultation at € 198, vs. € 177 for hospital consultations. These figures are broken down into staff, medication, hospital space, transportation, and various types of equipment. Cost appears to be per consultation.


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