Economic Evaluation of Telemedicine: Review of the Literature and Research Guidelines for Benefit–Cost Analysis

Economic evaluation methods for telemedicine include cost analysis, cost-effectiveness analysis, and benefit–cost analysis (BCA). Each has its strengths and weaknesses and often they don't give a complete picture. BCA is the most comprehensive of these three tools. A review of the literature was conducted to determine what has been done and what has not been done. The result of this review provides research guidelines for conducting BCA and introduces specific recommendations for future research. Telemedicine programs provide specialty health services to remote populations using telecommunications technology. This innovative approach to medical care delivery has been expanding for several years and currently covers various specialty areas such as cardiology, dermatology, and pediatrics. Economic evaluations of telemedicine, however, remain rare, and few of those conducted have accounted for the wide range of economic costs and benefits. Rigorous benefit–cost analyses of telemedicine programs could provide credible and comparative evidence of their economic viability and thus lead to the adoption and/or expansion of the most successful programs. To facilitate more advanced economic evaluations, this article presents research guidelines for conducting benefit–cost analyses of telemedicine programs, emphasizing opportunity cost estimation, commonly used program outcomes, and monetary conversion factors to translate outcomes to dollar values. The article concludes with specific recommendations for future research.