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The cost impact of telehealth interventions in pediatric surgical specialties: A systematic review

      Highlights

      • -
        What is currently known about the topic?
        • Telehealth is a rapidly expanding care modality across the United States.
        • Particularly in the wake of the COVID-19 pandemic.
      • -
        What new information is contained in this article?
        • Telehealth can be effectively deployed across a variety of pediatric surgical.
        • Specialties to lessen financial burdens to patients and their families.

      Abstract

      Background

      Telehealth is a rapidly expanding care modality in the United States. Pediatric surgical patients often require complex care which can incur significant expenses, some of which may be alleviated by telehealth. We performed a systematic review comparing telehealth and in-person visits, and telehealth's impacts on the cost of healthcare across pediatric surgical specialties.

      Methods

      A systematic review was performed using the following databases: PubMed (MEDLINE), Scopus (Elsevier), and CINAHL (EBSCOHost), searched from inception to July 10th, 2022. Studies were included per the following criteria: (1) investigated a telehealth intervention for pediatric surgical care and (2) provided some metric of telehealth cost compared to an in-person visit. Non-English or studies conducted outside of the U.S. were excluded.

      Results

      Fourteen manuscripts met inclusion criteria and presented data on 7992 visits, including patients with a weighted average age of 7.5 ± 3.5 years. Most (11/14) studies used telehealth in a synchronous, or “real-time” context. Of the studies which calculated dollar cost savings for telehealth visits compared to in-person appointments we found a substantial range of savings per visit, from $48.50 to $344.64. Cost savings were frequently realized in terms of reduced travel expenditures, lower opportunity costs (e.g. lost wages), and decreased hospital labor requirements.

      Conclusions

      This review suggests that telehealth provides cost incentives to pediatric surgical care in many scenarios, including post-operative visits and some routine clinic visits. Future work should focus on standardizing the metrics by which cost impacts are analyzed and detailing which visits are most appropriately facilitated by telehealth.

      Level of evidence

      V.

      Keywords

      Abbreviations:

      PRISMA (preferred reporting items for systematic reviews and meta-analyses), QALY (quality-adjusted life years)
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