Economic evaluation of the utilization of telemedicine for patients with cardiovascular disease: a systematic review

  • Hiro Farabi
  • Aziz RezapourEmail author
  • Reza Jahangiri
  • Abdosaleh Jafari
  • Asma Rashki Kemmak
  • Shima Nikjoo


Cardiovascular disease is one of the major causes of mortality in the world, with high human and financial burdens on communities. Telemedicine is a tool for providing services for patients that are difficult to access or in need of immediate care. The aim of this study was to systematically review economic evaluation studies that compared telemedicine with usual care for cardiovascular patients. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and related articles published up to December 2018 were searched in different databases (PubMed, Embase, SCOPUS, Global Health, Google Scholar, Magiran, SID). The articles were selected based on inclusion and exclusion criteria. Consolidated health economic evaluation reporting standards statement checklist was used to qualitatively evaluate the papers. Overall, 20 articles were included in the study. The studies used quality-adjusted life years to measure outcomes. The highest and lowest values of Incremental Cost-effectiveness Ratio were $515,082 and $2099 that had been reported in the UK and New Zealand, respectively. Most of the items of the checklist were reported and the quality of most of the studies was excellent and very good. According to the results, telemedicine improves the clinical outcomes and results in considerable saving in costs. Utilizing telemedicine concurrent with the usual care for service delivery is more cost-effective. The reviewed studies had been conducted in high-income countries, hence, it is essential to be cautious when generalizing the results and applying them in health systems policymaking.


Cardiovascular disease Telemedicine Economic evaluation Cost-benefit analysis Systematic review 


Funding information

This study was part of a research project that is supported by the health management and economics research center affiliated to Iran University of Medical Sciences (Project No. 97-1-48-12599 and Ethical Code. IR.IUMS.REC.1397.483).

Compliance with ethical standards

The manuscript does not contain clinical studies or patient data.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hiro Farabi
    • 1
  • Aziz Rezapour
    • 2
    Email author
  • Reza Jahangiri
    • 2
  • Abdosaleh Jafari
    • 3
  • Asma Rashki Kemmak
    • 2
  • Shima Nikjoo
    • 2
  1. 1.Department of Health Economics, School of Health Management and Information SciencesIran University of Medical SciencesTehranIran
  2. 2.Health Management and Economics Research Center, School of Health Management and Information SciencesIran University of Medical SciencesTehranIran
  3. 3.Health Human Resources Research Centre, School of Management and Medical Information SciencesShiraz University of Medical SciencesShirazIran

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