Cost Analysis of a Digital Health Care Model in Sweden

Ekman, Björn

doi:10.1007/s41669-017-0059-7

Cited by 51 publications

(44 citation statements)

References 11 publications

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“…Therapists on average spent 47.3 min per participant each week, which was calculated as 60 min. Based on estimates for a digital primary care provider service in Sweden, 44 an indirect cost per consultation of €24 (management, office space, administration and support) was added for each therapist hour. Based on these numbers, the total intervention cost per participant amounted to approximately €430 (€54 web costs + €376 for 8 therapist hours).…”

Section: Resultsmentioning

confidence: 99%

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Chat- and internet-based cognitive–behavioural therapy in treatment of adolescent depression: randomised controlled trial

et al. 2018

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BackgroundDepression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.AimsTo evaluate the efficacy of internet-based cognitive–behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.MethodSeventy adolescents, 15–19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).ResultsSignificant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22–1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.ConclusionsThe intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.Declaration of interestN.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.

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Section: Resultsmentioning

confidence: 99%

“…Results for guided internet intervention and digital primary care models are promising in terms of cost-effectiveness. 44 , 50 Multiple concurrent sessions (increasing capacity) is common practice in chat-based helplines for young people. 22 The next step is to investigate whether this can be generalised to chat sessions in iCBT.…”

Section: Discussionmentioning

confidence: 99%

Chat- and internet-based cognitive–behavioural therapy in treatment of adolescent depression: randomised controlled trial

et al. 2018

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“…A primary care service based mainly on a digital-first model (including video and/or telephone consultations) has obvious advantages. It provides patients with convenient access to health care advice without leaving home or work, offering savings in time and travel costs to patients and productivity gains for society [ 21 ]. It improves access in sparsely populated areas where physically getting to a GP may be problematic.…”

Section: Advantages Of Video Consultation Services In Primary Carementioning

confidence: 99%

Private Video Consultation Services and the Future of Primary Care

Salisbury¹,

Quigley²,

Hex³

et al. 2020

J Med Internet Res

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In many countries, private companies provide primary care services based predominantly on offering video consultations via smartphones. One example is Babylon GP at Hand (BGPaH), which offers video consultations to National Health Service patients, 24 hours a day, and has grown rapidly in London over the last 3 years. The development of this type of service has been controversial, particularly in the United Kingdom, but there has been little formal published evaluation of these services in any country. This paper outlines the main controversies about the use of privately provided video consultation services for primary care and shows how they are informed by the limited evaluations that have been conducted, particularly the evaluation of BGPaH. This paper describes the advantages of these services in terms of convenience, speed of access, the ability to consult without traveling or face-to-face patient-doctor contact, and the possibility of recruiting doctors who cannot work in conventional settings or do not live near the patients. It also highlights the concerns and uncertainties about quality and safety, demand, fragmentation of care, impact on other health services, efficiency, and equity. There are questions about whether private primary care services based on video consultations have a sustainable business model and whether they will undermine other health care providers. During the recent COVID-19 pandemic, the use of video consulting has become more widespread within conventional primary care services, and this is likely to have lasting consequences for the future delivery of primary care. It is important to understand the extent to which lessons from the evaluation of BGPaH and other private services based on a video-first model are relevant to the use of video consulting within conventional general practices, and to consider the advantages and disadvantages of these developments, before video consultation–based services in primary care become more widely established.

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“…As regards economic consequences of digitalisation in health care and social care, the most common points raised in the literature review are time saving potentials, and improvements in accessibility and availability. Scandinavian research suggests cost-saving advantages for implementing a digital health care model for primary care in Sweden (Ekman, 2018). In elderly care, the economic potential of introducing digital services is estimated to make a contribution to savings of up to 50% in Swedish municipalities, with metropolitan areas having the largest potential for savings (Forzati & Mattson 2014).…”

Section: Economic Regional Development Effectsmentioning

confidence: 99%