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Can telehealth reduce health care expenditure? A lesson from German health insurance data

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  • Andree Ehlert
  • Dirk Oberschachtsiek

Abstract

This study analyzes a telemedical program for chronic heart failure in Germany with respect to economic and treatment indicators. The program entails a routine data‐based preselection of the insured and specific treatment intensities for low‐ and high‐risk patients. This study complements previous research by considering differentiated end points such as mortality and rehospitalization as well as ambulatory, outpatient, and medication costs to account for potential cost shifts. In addition, different time frames and regional characteristics are dealt with. A difference‐in‐differences approach accounts for potential self‐selection into the voluntary program. Our results challenge the current paradigm of program‐induced cost shifting between hospital and ambulatory care. Except for a short‐term effect in the lower‐risk group, the program is associated with raising hospital admission rates as well as higher costs in all categories, while mortality is significantly reduced. The findings are robust as to various sensitivity checks.

Suggested Citation

  • Andree Ehlert & Dirk Oberschachtsiek, 2019. "Can telehealth reduce health care expenditure? A lesson from German health insurance data," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1121-1132, October.
  • Handle: RePEc:bla:ijhplm:v:34:y:2019:i:4:p:1121-1132
    DOI: 10.1002/hpm.2764
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    1. Lawrence C. Hamilton, 1992. "How Robust is Robust Regression?," Stata Technical Bulletin, StataCorp LP, vol. 1(2).
    2. Schreyögg, Jonas & Grabka, Markus M., 2010. "Copayments for Ambulatory Care in Germany: A Natural Experiment Using a Difference-in-Difference Approach," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 11(3), pages 331-341.
    3. Card, David & Krueger, Alan B, 1994. "Minimum Wages and Employment: A Case Study of the Fast-Food Industry in New Jersey and Pennsylvania," American Economic Review, American Economic Association, vol. 84(4), pages 772-793, September.
    4. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, April.
    5. Billor, Nedret & Hadi, Ali S. & Velleman, Paul F., 2000. "BACON: blocked adaptive computationally efficient outlier nominators," Computational Statistics & Data Analysis, Elsevier, vol. 34(3), pages 279-298, September.
    6. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    7. Becker, Christian & Holle, Rolf & Stollenwerk, Björn, 2015. "The excess health care costs of KardioPro, an integrated care program for coronary heart disease prevention," Health Policy, Elsevier, vol. 119(6), pages 778-786.
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