The British Medical Journal (BMJ) has published research showing the cost effectiveness of tele-health for patients with long term conditions. The “primary outcome for the cost effectiveness analysis was incremental cost per quality adjusted life year (QALY) gained.” This was based on a “net benefit analyses of costs and outcomes for 965 patients (534 receiving telehealth; 431 usual care). The adjusted mean difference in QALY gain between groups at 12 months was 0.012. Total health and social care costs (including direct costs of the intervention) for the three months before 12 month interview were £1,390 and £1,596 for the usual care and telehealth groups, respectively.”
The analysis extrapolated these benefits based on UK Government data on the number of people with a variety of relevant long term conditions, chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD) and diabetes to calculate the potential triple bottom-line benefits of the telehealth and telecare approach. The analysis made assumptions that there would be reductions in service use and cost savings from increased capacity 80% reductions of equipment costs. In the analysis a conservative assumption was made that one cohort is 2% of people with long term conditions – CHD, diabetes, COPD per year, based on one cohort per year for five years. The reduction in service use is considered to save carbon emissions though the analysis ignores carbon emissions resulting from the telehealthcare service itself as this is expected to be very low carbon intensity.
Case study source
Whole systems demonstrator telehealth trials –
Healthy Returns – Production Reports
Financial Calculations
Savings
Savings per person based on increased capacity and 80% reduction in equipment prices were £49 according to the analysis carried out for the SDU Healthy Returns report. The number of people expected to be migrated to telehealth each year is 104,660, so the savings are calculated as £5,100,000 (allowing for some rounding) per annum. Assuming a 50% uptake rate gives savings of approximately £2,550,000.
Carbon Calculations
The conclusion of the Healthy Returns study is a 5 year carbon saving of 67,000 tCO2e, therefore the annual carbon savings used for the MACC calculations is 13,500 tCO2e multiplied by a 50% uptake rate to give approximately 6,700 tCO2e.
Ignores carbon emissions resulting from the telehealthcare service itself as this is expected to be very low carbon intensity. Carbon savings are calculated based on different types of service use reductions.
Additional Benefits
Additional benefits from delivering healthcare services using teleconferencing include large increases in efficiency by reducing staff travel time. For example 3000 hours were saved at NHS Derbyshire Community Health Services from telehealth services. Telehealth reduces health inequality by increasing access to health services to those who might only receive interventions minor issues develop into more acute problems.
The annual Labour Force Survey carried out by the Office for National Statistics shows that in 2011 36% of all accidents, that resulted in injury, occurred while travelling on company business (excluding commuting). Reducing the need to travel also reduces the risk of car accidents and work related injury. The loss of productivity and due to these accidents is a material benefit from increased use of telehealth services.
Assumptions
Take costs from over-capacity and 80% of equipment costs (justification: economies of scale)
One cohort is 2% of people with long term conditions – CHD, diabetes, COPD per year (justification: conservative). Assume one cohort per year for five years.
Not using resources saves carbon.
Ignores carbon used by tele-healthcare service – would be preferable if this could be very low carbon.