Cost-Effectiveness Analysis of Telemedicine Implementation in the Management of Non-Communicable Diseases in Hospitals

Abstract

Non-communicable diseases (NCDs) remain the leading cause of morbidity and mortality, necessitating continuous and efficient care delivery. Telemedicine has emerged as an innovative approach to enhance healthcare accessibility, efficiency, and patient adherence. This study analyzes the costeffectiveness of telemedicine implementation in managing chronic diseases within hospital settings using a mixed-method design with a sequential explanatory approach. Quantitative data were obtained through Cost-Effectiveness Analysis (CEA) of inpatient records for NCD patients over one semester, while qualitative insights were derived from in-depth interviews with hospital managers, Hospital Management Information System (HMIS) teams, and Electronic Medical Record (EMR) administrators. Findings indicate that telemedicine could potentially reduce 19 hospitalizations, with an incremental cost of IDR 134.1 million and an average Incremental Cost-Effectiveness Ratio (ICER) of IDR 7.1 million per avoided admission. The highest cost-effectiveness was observed in ischemic heart disease cases (ICER IDR 6.8 million), offering additional benefits such as time efficiency, shorter queues, and lower transportation costs. Nonetheless, barriers were identified in financing policies, human resource preparedness, and network infrastructure. In conclusion, telemedicine demonstrates relative cost-effectiveness in NCD management, particularly for ischemic heart disease and type 2 diabetes mellitus, highlighting the need for strengthened policies, infrastructure, and workforce capacity to support sustainable implementation.