Telehealth as a Care Solution for Homebound People: Systematic Review and Meta-Analysis of Healthcare Utilization, Quality of Life, and Well-Being Outcomes
Corresponding Author
Maria Alejandra Pinero de Plaza
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Faculty of Health and Medical Sciences , Adelaide University , Adelaide , Australia , adelaide.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorAarti Gulyani
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorLemma N. Bulto
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Health Evidence Synthesis , Recommendations and Impact (HESRI) , School of Public Health , The University of Adelaide , Adelaide, South Australia , Australia , adelaide.edu.au
Search for more papers by this authorRegina Allande-Cussó
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
College of Nursing , University of Seville , Seville , Spain , us.es
Search for more papers by this authorVincent Pearson
JBI , School of Public Health , Faculty of Health and Medical Sciences , The University of Adelaide , Adelaide , South Australia, Australia , adelaide.edu.au
Search for more papers by this authorBelinda Lange
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorTania Marin
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorLemlem Gebremichael
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorShannon Brown
Flinders University Library , Flinders University , Adelaide , South Australia, Australia , flinders.edu.au
Search for more papers by this authorHila Dafny
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorShelda Sajeev
Centre for Artificial Intelligence Research and Optimization , Torrens University , Adelaide , Australia
Defence Electronic Warfare and Communications Services (DEWC Services) , Adelaide , Australia
Search for more papers by this authorNorma Bulamu
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorAlline Beleigoli
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorKatie Nesbitt
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorPenelope McMillan
ME/CFS South Australia Inc , Adelaide , Australia
Search for more papers by this authorRobyn Clark
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorMatthew Tieu
Faculty of Health and Medical Sciences , Adelaide University , Adelaide , Australia , adelaide.edu.au
Search for more papers by this authorAlison Kitson
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorStephanie Champion
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorSonia Hines
Faculty of Health and Medical Sciences , Adelaide University , Adelaide , Australia , adelaide.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorJeroen M. Hendriks
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Centre for Heart Rhythm Disorders , The University of Adelaide and Royal Adelaide Hospital , Adelaide , Australia
Department of Nursing , Maastricht University Medical Centre , Maastricht , the Netherlands , mumc.nl
Department of Health Services Research , Care and Public Health Research Institute , Maastricht , the Netherlands
Search for more papers by this authorCorresponding Author
Maria Alejandra Pinero de Plaza
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Faculty of Health and Medical Sciences , Adelaide University , Adelaide , Australia , adelaide.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorAarti Gulyani
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorLemma N. Bulto
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Health Evidence Synthesis , Recommendations and Impact (HESRI) , School of Public Health , The University of Adelaide , Adelaide, South Australia , Australia , adelaide.edu.au
Search for more papers by this authorRegina Allande-Cussó
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
College of Nursing , University of Seville , Seville , Spain , us.es
Search for more papers by this authorVincent Pearson
JBI , School of Public Health , Faculty of Health and Medical Sciences , The University of Adelaide , Adelaide , South Australia, Australia , adelaide.edu.au
Search for more papers by this authorBelinda Lange
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorTania Marin
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorLemlem Gebremichael
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorShannon Brown
Flinders University Library , Flinders University , Adelaide , South Australia, Australia , flinders.edu.au
Search for more papers by this authorHila Dafny
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorShelda Sajeev
Centre for Artificial Intelligence Research and Optimization , Torrens University , Adelaide , Australia
Defence Electronic Warfare and Communications Services (DEWC Services) , Adelaide , Australia
Search for more papers by this authorNorma Bulamu
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorAlline Beleigoli
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorKatie Nesbitt
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorPenelope McMillan
ME/CFS South Australia Inc , Adelaide , Australia
Search for more papers by this authorRobyn Clark
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorMatthew Tieu
Faculty of Health and Medical Sciences , Adelaide University , Adelaide , Australia , adelaide.edu.au
Search for more papers by this authorAlison Kitson
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorStephanie Champion
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Search for more papers by this authorSonia Hines
Faculty of Health and Medical Sciences , Adelaide University , Adelaide , Australia , adelaide.edu.au
Mparntwe Centre for Evidence in Health , A JBI Centre of Excellence , Flinders University , Alice Springs , Australia , flinders.edu.au
Search for more papers by this authorJeroen M. Hendriks
Caring Futures Institute , College of Nursing and Health Sciences , Flinders University , Adelaide , Australia , flinders.edu.au
Centre for Heart Rhythm Disorders , The University of Adelaide and Royal Adelaide Hospital , Adelaide , Australia
Department of Nursing , Maastricht University Medical Centre , Maastricht , the Netherlands , mumc.nl
Department of Health Services Research , Care and Public Health Research Institute , Maastricht , the Netherlands
Search for more papers by this authorAbstract
Homebound individuals residing in community settings with severe health conditions and disabilities could arguably benefit from telehealth interventions. However, the effectiveness of telehealth compared to in-person care remains underexplored, considering the diversity of these groups. This systematic review and meta-analysis aimed to evaluate the effectiveness of telehealth in reducing healthcare utilization and improving health-related quality of life (HRQOL) and well-being in homebound populations. Adhering and expanding on a published protocol, we conducted comprehensive search across multiple databases: MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, LILACS, and the Web of Science, with no restrictions on language or publication date, and experimental and quasiexperimental studies considered. Eleven independent reviewers were responsible for study selection, and three for data extraction. The methodological quality of the included studies was assessed using JBI checklists. A meta-analysis was then performed using Stata software, which reported standardized mean differences (SMDs) as the effect measure, with the quality of evidence evaluated using the GRADE approach. From an initial screening of 3289 articles, ten studies met our inclusion criteria, with eight suitable for meta-analysis. These studies encompassed data from 2245 participants. Our findings revealed that telehealth interventions significantly reduced healthcare utilization (SMD: −0.49; 95% CI: −0.76 to −0.22; p < 0.01, GRADE: low certainty), significantly enhanced HRQOL (SMD: 0.18; 95% CI: 0.01 to 0.35; p = 0.04, GRADE: moderate certainty), and significantly improved well-being (SMD: −0.31; 95% CI: −0.47 to −0.15; p < 0.01, GRADE: moderate certainty) compared to in-person care. Thus, telehealth emerges as a viable alternative to conventional care, significantly reducing healthcare utilization and enhancing both HRQOL and well-being for homebound people. These findings underscore the potential of telehealth to mitigate healthcare disparities and emphasize the need for accessible, equitable telehealth services codeveloped with end users and relevant stakeholders to save resources and maximize health outcomes for vulnerable populations in community settings.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available within the article. Further data may be available from the corresponding author upon reasonable request.
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