{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:57:30Z","timestamp":1793350650746,"version":"4.5.0"},"reference-count":23,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Patients with cancer typically have greater financial hardships and time costs than individuals without cancer. The COVID-19 pandemic has exacerbated this, while posing substantial challenges to delivering cancer care and resulting in important changes in care-delivery models, including the rapid adoption of telehealth.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To estimate patient travel, time, and cost savings associated with telehealth for cancer care delivery.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n An economic evaluation of cost savings from completed telehealth visits from April 1, 2020, to June 30, 2021, in a single-institution National Cancer Institute\u2013Designated Comprehensive Cancer Center. All patients aged 18 to 65 years who completed telehealth visits within the designated time frame and had a Florida mailing address documented in their electronic medical record were included in the study cohort. Data were analyzed from April 2020 to June 2021.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcome was estimated patient cost savings from telehealth, which included 2 components: costs of travel (defined as roundtrip distance saved from car travel) and potential loss of productivity due to the medical visit (defined as loss of income from roundtrip travel plus loss of income from in-person clinic visits). Two different models with a combination of 2 different mileage rates ($0.56 and $0.82 per mile) and census tract\u2013level median hourly wages were used.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The study included 25\u202f496 telehealth visits with 11\u202f688 patients. There were 4525 (3795 patients) new or established visits and 20\u202f971 (10\u202f049 patients) follow-up visits. Median (IQR) age was 55.0 (46.0-61.0) years among the telehealth visits, with 15\u202f663 visits (61.4%) by women and 18\u202f360 visits (72.0%) by non-Hispanic White patients. According to cost models, the estimated mean (SD) total cost savings ranged from $147.4 ($120.1) at $0.56\/mile to $186.1 ($156.9) at $0.82\/mile. For new or established visits, the mean (SD) total cost savings per visit ranged from $176.6 ($136.3) at $0.56\/mile to $222.8 ($177.4) at $0.82\/mile, and for follow-up visits, the mean (SD) total cost savings per visit was $141.1 ($115.3) at $0.56\/mile to $178.1 ($150.9) at $0.82\/mile.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this economic evaluation, telehealth was associated with savings in patients time and travel costs, which may reduce the financial toxicity of cancer care. Expansion of telehealth oncology services may be an effective strategy to reduce the financial burden among patients with cancer.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.50211","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T11:07:51Z","timestamp":1673348871000},"page":"e2250211","source":"Crossref","is-referenced-by-count":182,"title":["Estimated Indirect Cost Savings of Using Telehealth Among Nonelderly Patients With Cancer"],"prefix":"10.1001","volume":"6","author":[{"given":"Krupal B.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Head and Neck and Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida"},{"name":"Department of Otolaryngology, Head and Neck Surgery, University of South Florida, Tampa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kea","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Alishahi Tabriz","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura B.","family":"Oswald","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Rock","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather S. L.","family":"Jim","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony C.","family":"Nichols","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmondo","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, Florida"},{"name":"Center for Digital Health, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Naso","sequence":"additional","affiliation":[{"name":"Virtual Health Program, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe E.","family":"Spiess","sequence":"additional","affiliation":[{"name":"Virtual Health Program, Moffitt Cancer Center, Tampa, Florida"},{"name":"Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"issue":"7","key":"zoi221423r1","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1093\/annonc\/mdz140","article-title":"Methods for measuring financial toxicity after cancer diagnosis and treatment: a systematic review and its implications.","volume":"30","author":"Witte","year":"2019","journal-title":"Ann Oncol"},{"issue":"2","key":"zoi221423r2","first-page":"80","article-title":"Financial toxicity, part I: a new name for a growing problem.","volume":"27","author":"Zafar","year":"2013","journal-title":"Oncology (Williston Park)"},{"issue":"12","key":"zoi221423r3","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1158\/1055-9965.EPI-18-0617","article-title":"Medical financial hardship among cancer survivors in the United States: what do we know? What do we need to know?","volume":"27","author":"Yabroff","year":"2018","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"7","key":"zoi221423r4","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1097\/MLR.0000000000000151","article-title":"Annual patient time costs associated with medical care among cancer survivors in the United States.","volume":"52","author":"Yabroff","year":"2014","journal-title":"Med Care"},{"issue":"1","key":"zoi221423r5","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1093\/jnci\/djk001","article-title":"Patient time costs associated with cancer care.","volume":"99","author":"Yabroff","year":"2007","journal-title":"J Natl Cancer Inst"},{"issue":"12","key":"zoi221423r6","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1093\/jnci\/djab192","article-title":"Annual report to the nation on the status of cancer, part 2: patient economic burden associated with cancer care.","volume":"113","author":"Yabroff","year":"2021","journal-title":"J Natl Cancer Inst"},{"issue":"6","key":"zoi221423r7","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1016\/j.eururo.2020.06.025","article-title":"Telehealth in urology: a systematic review of the literature. how much can telemedicine be useful during and after the COVID-19 pandemic?","volume":"78","author":"Novara","year":"2020","journal-title":"Eur Urol"},{"issue":"1","key":"zoi221423r8","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jval.2021.10.008","article-title":"Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 explanation and elaboration: a report of the ISPOR CHEERS II Good Practices Task Force.","volume":"25","author":"Husereau","year":"2022","journal-title":"Value Health"},{"issue":"10","key":"zoi221423r9","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1001\/jama.2016.12195","article-title":"Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine.","volume":"316","author":"Sanders","year":"2016","journal-title":"JAMA"},{"issue":"16","key":"zoi221423r14","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1056\/NEJMsr1503323","article-title":"Telehealth.","volume":"377","author":"Tuckson","year":"2017","journal-title":"N Engl J Med"},{"issue":"12","key":"zoi221423r15","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1634\/theoncologist.2015-0110","article-title":"Distance as a barrier to cancer diagnosis and treatment: review of the literature.","volume":"20","author":"Ambroggi","year":"2015","journal-title":"Oncologist"},{"issue":"8","key":"zoi221423r16","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1634\/theoncologist.2019-0146","article-title":"Addressing the financial burden of cancer clinical trial participation: longitudinal effects of an equity intervention.","volume":"24","author":"Nipp","year":"2019","journal-title":"Oncologist"},{"issue":"6","key":"zoi221423r17","doi-asserted-by":"publisher","first-page":"815","DOI":"10.2105\/AJPH.2020.305579","article-title":"Transportation barriers to health care in the United States: findings from the National Health Interview Survey, 1997-2017.","volume":"110","author":"Wolfe","year":"2020","journal-title":"Am J Public Health"},{"issue":"8","key":"zoi221423r18","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1001\/jamaoncol.2020.1475","article-title":"Assessment of parking fees at National Cancer Institute-designated cancer treatment centers.","volume":"6","author":"Lee","year":"2020","journal-title":"JAMA Oncol"},{"issue":"1","key":"zoi221423r19","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1097\/SLA.0000000000003366","article-title":"Trends in the geospatial distribution of inpatient adult surgical services across the United States.","volume":"273","author":"Diaz","year":"2021","journal-title":"Ann Surg"},{"issue":"4","key":"zoi221423r20","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1089\/153056203772744680","article-title":"The impact of telemedicine on patients\u2019 cost savings: some preliminary findings.","volume":"9","author":"Bynum","year":"2003","journal-title":"Telemed J E Health"},{"issue":"10","key":"zoi221423r22","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1001\/jamainternmed.2020.2666","article-title":"Assessment of disparities in digital access among medicare beneficiaries and implications for telemedicine.","volume":"180","author":"Roberts","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"1","key":"zoi221423r23","doi-asserted-by":"publisher","DOI":"10.2196\/29635","article-title":"Health care providers\u2019 and professionals\u2019 experiences with telehealth oncology implementation during the COVID-19 pandemic: a qualitative study.","volume":"24","author":"Turner","year":"2022","journal-title":"J Med Internet Res"},{"key":"zoi221423r10","unstructured":"American Community Survey (ACS)? 2019. Accessed November 30, 2022. https:\/\/www.census.gov\/programs-surveys\/acs"},{"key":"zoi221423r11","unstructured":"Buxton Co. Accessed October 15, 2021. https:\/\/www.buxtonco.com\/"},{"key":"zoi221423r12","unstructured":"Alteryx. Accessed October 15, 2021. https:\/\/www.alteryx.com\/"},{"key":"zoi221423r13","unstructured":"R: a language and environment for statistical computing. 2019. Accessed November 30, 2022. https:\/\/www.R-project.org\/"},{"key":"zoi221423r21","unstructured":"National Alliance for Caregiving (NAC) in Collaboration with AARP. Caregiving in the US. May 2020. Accessed October 31, 2021. https:\/\/www.caregiving.org\/wp-content\/uploads\/2021\/01\/full-report-caregiving-in-the-united-states-01-21.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2800164\/patel_2023_oi_221423_1675271594.4507.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T11:03:40Z","timestamp":1675940620000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2800164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.50211","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]}}}