Cost-Effectiveness Analysis of Telehealth and In-Person Primary Care Visits for People Living with Alzheimer’s Disease-Related Disorders in the State of Nevada

Yonsu Kim, Jay J. Shen, Ian Choe, Jerry Reeves, David Byun, Iulia Ioanitoaia-Chaudhry, Leora Frimer, Pengfeng Jin, Maryam Tabrizi, Hee-Taik Kang, Jae-Woo Lee, Claire Sieun Lee, Tae-Ha Chung, Yena Hwang, Ian Park, Hayden Leung, Jenna Park and Ji Won Yoo ()
Additional contact information
Yonsu Kim: Department of Healthcare Administration and Healthcare Policy, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
Jay J. Shen: Department of Healthcare Administration and Healthcare Policy, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
Ian Choe: Digital Health Division, Nevada Optum Care, Las Vegas, NV 89128, USA
Jerry Reeves: Comagine Health, Las Vegas, NV 89118, USA
David Byun: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Iulia Ioanitoaia-Chaudhry: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Leora Frimer: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Pengfeng Jin: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Maryam Tabrizi: School of Dental Medicine, University of Nevada, Las Vegas, NV 89154, USA
Hee-Taik Kang: Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
Jae-Woo Lee: Department of Family Medicine, College of Medicine, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea
Claire Sieun Lee: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Tae-Ha Chung: Department of Family Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
Yena Hwang: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Ian Park: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Hayden Leung: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Jenna Park: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
Ji Won Yoo: Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA

IJERPH, 2024, vol. 21, issue 10, 1-10

Abstract: To people living with Alzheimer’s Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. To evaluate the cost-effectiveness of telehealth visits for people living with ADRD in the state of Nevada, a decision-analytic Markov model was developed from healthcare system perspectives with a 10-year horizon/1-year cycle. To estimate the effects of demographic and geographic parameters on the Markov model, race parameters were divided into non-Hispanic White individuals vs. others and location parameters were divided into urban vs. rural. A 12-item short-version Zarit Burden Interview (ZBI-12) was applied to measure the informal caregiver burdens of non-institutionalized people living with ADRD. The values of mortality rate and healthcare utilization were obtained from healthcare systems’ publicly available payor administrative data and Nevada State Inpatient/Emergency Department datasets. Among urban-residing non-Hispanic White individuals, the Incremental Cost-Effectiveness Ratio (ICER) per modified ZBI-12 indicated a cost saving of USD 9.44 with telehealth visits; among urban-residing racial minorities, the ICER per modified ZBI-12 indicated a cost saving of USD 29.26 with in-person visits; and among rural residents, the ICER per modified ZBI-12 indicated a cost-saving of USD 320.93 with telehealth visits. Distributional differences in the cost-saving effects of telehealth primary care were noted in line with racial and geographic parameters. Workforce and caregiver training is necessary for reducing distributional differences, especially among urban-residing racial monitories living with ADRD in the provider shortage area of the state of Nevada.

Keywords: Alzheimer’s; cost-effectiveness; distribution; minorities; primary care; race; telehealth (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/21/10/1381/pdf (application/pdf)
https://www.mdpi.com/1660-4601/21/10/1381/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:21:y:2024:i:10:p:1381-:d:1501813

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().