Mixed methods evaluation of the cost benefit of a telehealth programme for chronic obstructive pulmonary disease in NHS Highland

Student thesis: Master's Thesis

Abstract

This thesis examines the potential cost-benefit of the Home and Mobile Health Monitoring (HMHM) programme, which is a telehealth programme for patients with chronic obstructive pulmonary disease (COPD) in NHS Highland. COPD was chosen as it is a common and expensive long-term condition. The HMHM programme could be a solution for better monitoring of COPD if it could provide economic savings for NHS Highland for patients with severe COPD who used the programme to monitor their condition. Mixed methods were used to conduct an economic evaluation. Quantitative and qualitative methods were used to collect costs and benefits data for the economic evaluation through interviews and an online survey with experts on the HMHM programme for COPD patients. Interviews were also used to gather patient perspectives (by proxy) as well as those of clinicians, academics, and service managers, and to ask them to highlight the perceived benefits for the patients, clinicians and NHS Highland. From the i nterviews, it was found that patients and clinicians are satisfied with the programme. Furthermore, the both the patients and clinicians involved in the programme are reported as having gained various benefits from the programme, for example patients felt satisfied with that programme and also clinicians supported that this programme was less labour intensive. The challenges of implementing the programme in NHS Highland and Scotland and more generally of measuring the costs and benefits of the HMHM programme were explored. Some of these challenges include the difficulty to persuade patients to use their mobile phone for texting, another was that the NHS do not have actual proof that the programme works, and other challenge was that the participants were not representable of the whole COPD population as they had at least one hospital admission. This thesis found that the HMHM programme is a beneficial solution for the NHS, as it enabled the NHS to achieve estimated cost savings of£8,819.55 for the group of people who used the HMHM programme in NHS Highland. Interventions such as the HMHM programme can help patients who have severe long-term conditions to have better control of their disease and to be more independent, while the NHS can achieve cost savings because of the reduced need for hospitalisation from acute exacerbations This thesis has demonstrated that while challenges still exist around properly measuring the costs and benefits of telehealth it is possible that the HMHM programme worked and provide a cost-effective solution for the NHS. The contribution of this thesis was the cost benefit analysis that is an economic evaluation method which is not used very often because of the limitations that they face. The CBA is a valuable method why indicate in monetary units whether it worth it or not to do an intervention.
Date of Award9 Jun 2020
Original languageEnglish
Awarding Institution
  • University Of Strathclyde
SponsorsUniversity of Strathclyde
SupervisorMarilyn Lennon (Supervisor) & Matt-Mouley Bouamrane (Supervisor)

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