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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

Author

Listed:
  • 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
    Center for Health Disparities Research, 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
    Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, 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
    Department of Medicine, William Bee Ririe Rural Health Hospital and Clinic, Ely, NV 89301, USA
    Department of Medicine, Veterans Affairs Southern Nevada Health Care, North Las Vegas, NV 89086, USA)

  • Iulia Ioanitoaia-Chaudhry

    (Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, USA
    Geriatric Education Center, Veterans Affairs Southern Nevada Health Care, North Las Vegas, NV 89086, 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)

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.

Suggested Citation

  • 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 Chun, 2024. "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," IJERPH, MDPI, vol. 21(10), pages 1-10, October.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:10:p:1381-:d:1501813
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    References listed on IDEAS

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