Knowing the costs of change: an introduction to health economic analyses and considerations for their use in implementation research

Burns, Clare L.; Wishart, Laurelie R; Kularatna, Sanjeewa; Ward, Elizabeth C.

doi:10.1080/2050571x.2019.1693750

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…Finally, the cost attributed with delivering a clinical service is a key factor impacting sustainability [ 92 ] and must be part of the evaluation of any service model. Telepractice services can be examined with a variety of economic analysis methods [ 101 ] which may include cost-minimization analysis, cost-effectiveness analysis, cost–benefit analysis, and cost-consequence analysis [ 92 , 102 ]. In particular, Snoswell et al [ 103 ] emphasized the importance of taking a broader societal perspective when evaluating telepractice models to enable capture of extra clinical costs such as patient-funded travel or loss of productivity.…”

Section: Discussionmentioning

confidence: 99%

“…To this end, ensuring that there is systematic research into both the costs, as well as the cost-effectiveness of telepractice models in dysphagia care is a clear direction for future research. Undertaking robust economic analyses in collaboration with health economists will ensure that decision-makers have the necessary evidence to determine the potential benefit of telepractice, and hypothesize changes in cost-effectiveness of service models implemented under different conditions [ 102 ].…”

Section: The Future Of Telepractice Researchmentioning

confidence: 99%

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Telepractice and Dysphagia Management: The Era of COVID-19 and Beyond

et al. 2022

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The COVID-19 pandemic drove rapid and widespread uptake of telepractice across all aspects of healthcare. The delivery of dysphagia care was no exception, with telepractice recognized as a service modality that could support social distancing/infection control, overcome service delivery challenges created by lockdowns/service closures, and address consumer concerns about attending in-person appointments. Now, almost two years since most services first rapidly deployed telepractice, it is time to reflect on the big picture, and consider how telepractice will continue as a service option that is sustained and integrated into mainstream dysphagia care. It is also timely to consider the research agenda needed to support this goal. To this end, in this paper we present 4 discussion topics, which raise key considerations for the current and future use of telepractice within adult and pediatric dysphagia services. These are (1) Dysphagia services must meet consumer and service needs; (2) Aspects of dysphagia services can be safely and reliably provided via telepractice; (3) Telepractice can be used in flexible ways to support the delivery of dysphagia services; and (4) Providing quality dysphagia services via telepractice requires planned implementation and evaluation. Then directions for future research are discussed. These considerations are presented to help shift perspectives away from viewing telepractice as simply a COVID-19 “interim-care solution”. Rather, we encourage clinicians, services, and researchers to embrace a future of “integrated care”, where traditional dysphagia services are combined with telepractice models, to enhance the quality of care provided to our clients.

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Section: Discussionmentioning

confidence: 99%

Section: The Future Of Telepractice Researchmentioning

confidence: 99%

Telepractice and Dysphagia Management: The Era of COVID-19 and Beyond

et al. 2022

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“…Furthermore, two reviewed articles conveyed support for the use of mobile applications and wearable devices for provision of telerehabilitation for dysphagia (Brodsky & Gilbert, 2020;Soldatova et al, 2020). Indeed, there are now several apps or devices that allow for remote tracking/ monitoring of the patient's performance on rehabilitative exercises, allowing for clinicians to be able to keep data, track progress, and provide feedback to patients (e.g., Burns, Wishart, et al, 2020;Constantinescu et al, 2017;Kim et al, 2019;Starmer et al, 2018;Wall et al, 2016). It is our hope that the development and validation of such technologies will be accelerated during this time and advanced research and commercialization efforts will help establish their role in the care of our patients.…”

Section: Swallowing Telerehabilitationmentioning

confidence: 99%

“…The majority of these studies has examined dysphagia tele-assessments (both clinical and televideofluoroscopic swallowing study [tele-VFSS]) and has repeatedly demonstrated that these assessments are safe, valid, and reliable when compared to traditional in-person dysphagia evaluations (Burns et al, 2019(Burns et al, , 2016Kantarcigil et al, 2016;Malandraki et al, 2011;Morrell et al, 2017;Perlman & Witthawaskul, 2002;Ward et al, 2013Ward et al, , 2009Ward et al, , 2012aWard et al, , 2012b. In the last few years, evidence for the use of teleconsultation and teletreatment sessions for dysphagia has also emerged with equally positive preliminary results (e.g., Burns et al, 2017;Burns, Wishart et al, 2020;Malandraki et al, 2013Malandraki et al, , 2014Wall et al, 2016). Additional documented benefits of this service delivery model for dysphagia management include service efficiency (Burns et al, 2017;Burns, Wishart et al, 2020), cost savings (Burns et al, 2019), clinician and patient/caregiver satisfaction (Burns et al, 2019;Malandraki et al, 2014;Ward et al, 2012b), and increased access to specialists leading to improved quality of care (Burns et al, 2017;Malandraki et al, 2013).…”

mentioning

confidence: 99%

“…In the last few years, evidence for the use of teleconsultation and teletreatment sessions for dysphagia has also emerged with equally positive preliminary results (e.g., Burns et al, 2017;Burns, Wishart et al, 2020;Malandraki et al, 2013Malandraki et al, , 2014Wall et al, 2016). Additional documented benefits of this service delivery model for dysphagia management include service efficiency (Burns et al, 2017;Burns, Wishart et al, 2020), cost savings (Burns et al, 2019), clinician and patient/caregiver satisfaction (Burns et al, 2019;Malandraki et al, 2014;Ward et al, 2012b), and increased access to specialists leading to improved quality of care (Burns et al, 2017;Malandraki et al, 2013).…”

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confidence: 99%

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Telehealth for Dysphagia Across the Life Span: Using Contemporary Evidence and Expertise to Guide Clinical Practice During and After COVID-19

Malandraki

Arkenberg

Mitchell

et al. 2021

Am J Speech Lang Pathol

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Purpose Our aim was to critically review recent literature on the use of telehealth for dysphagia during the COVID-19 pandemic and enhance this information in order to provide evidence- and practice-based clinical guidance during and after the pandemic. Method We conducted a rapid systematized review to identify telehealth adaptations during COVID-19, according to peer-reviewed articles published from January to August 2020. Of the 40 articles identified, 11 met the inclusion criteria. Full-text reviews were completed by three raters, followed by qualitative synthesis of the results and description of practical recommendations for the use of telehealth for dysphagia. Results Seven articles were guidelines articles, three were editorials, and one was a narrative review. One article focused on telehealth and dysphagia during COVID-19. The remaining 10 mentioned telehealth in varying degrees while focusing on dysphagia management during the pandemic. No articles discussed pediatrics in depth. The most common procedure for which telehealth was recommended was the clinical swallowing assessment (8/11), followed by therapy (7/11). Six articles characterized telehealth as a second-tier service delivery option. Only one article included brief guidance on telehealth-specific factors, such as legal safeguards, safety, privacy, infrastructure, and facilitators. Conclusions Literature published during the pandemic on telehealth for dysphagia is extremely limited and guarded in endorsing telehealth as an equivalent service delivery model. We have presented prepandemic and emerging current evidence for the safety and reliability of dysphagia telemanagement, in combination with practical guidelines to facilitate the safe adoption of telehealth during and after the pandemic.

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