{"id":"https://openalex.org/W7204452061","doi":"https://doi.org/10.3390/dhi1020008","title":"Telemedicine in Primary Care: A Scoping Review of Cost-Effectiveness in Singapore","display_name":"Telemedicine in Primary Care: A Scoping Review of Cost-Effectiveness in Singapore","publication_year":2026,"publication_date":"2026-11-09","ids":{"openalex":"https://openalex.org/W7204452061","doi":"https://doi.org/10.3390/dhi1020008"},"language":"en","primary_location":{"id":"doi:10.3390/dhi1020008","doi":"https://doi.org/10.3390/dhi1020008","is_oa":true,"landing_page_url":"https://doi.org/10.3390/dhi1020008","pdf_url":null,"source":{"id":"https://openalex.org/S7407057382","display_name":"Digital Health and Innovation","issn_l":"3042-9315","issn":["3042-9315"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Digital Health and Innovation","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","datacite"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.3390/dhi1020008","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5004289814","display_name":"Cheryl Zhiya Chong","orcid":"https://orcid.org/0000-0002-0492-1873","observed_orcids":["https://orcid.org/0000-0002-0492-1873"]},"institutions":[{"id":"https://openalex.org/I4210146690","display_name":"National University Hospital","ror":"https://ror.org/04fp9fm22","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I165932596","https://openalex.org/I4210146690","https://openalex.org/I4210150261"]},{"id":"https://openalex.org/I4210150261","display_name":"National University Health System","ror":"https://ror.org/05tjjsh18","country_code":"SG","type":"education","lineage":["https://openalex.org/I165932596","https://openalex.org/I4210150261"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Cheryl Zhiya Chong","raw_affiliation_strings":["National Preventive Medicine Residency, National University Health System, National University Hospital, Singapore 119074, Singapore"],"raw_orcid":"https://orcid.org/0000-0002-0492-1873","affiliations":[{"raw_affiliation_string":"National Preventive Medicine Residency, National University Health System, National University Hospital, Singapore 119074, Singapore","institution_ids":["https://openalex.org/I4210146690","https://openalex.org/I4210150261"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5087850878","display_name":"Rachel Y. Chong","orcid":"https://orcid.org/0000-0002-1114-7038","observed_orcids":["https://orcid.org/0000-0002-1114-7038"]},"institutions":[{"id":"https://openalex.org/I1291357265","display_name":"Ministry of Health","ror":"https://ror.org/00mrhvv69","country_code":"SG","type":"government","lineage":["https://openalex.org/I1291357265"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Ray Junrui Chong","raw_affiliation_strings":["Ministry of Health Holdings, Singapore 139691, Singapore"],"raw_orcid":"https://orcid.org/0000-0002-1114-7038","affiliations":[{"raw_affiliation_string":"Ministry of Health Holdings, Singapore 139691, Singapore","institution_ids":["https://openalex.org/I1291357265"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161315617","display_name":"Jia Hao Jonathan Chng","orcid":"https://orcid.org/0009-0009-5281-7171","observed_orcids":["https://orcid.org/0009-0009-5281-7171"]},"institutions":[{"id":"https://openalex.org/I4210146690","display_name":"National University Hospital","ror":"https://ror.org/04fp9fm22","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I165932596","https://openalex.org/I4210146690","https://openalex.org/I4210150261"]}],"countries":["SG"],"is_corresponding":true,"raw_author_name":"Jia Hao Jonathan Chng","raw_affiliation_strings":["Pathology Department, National University Hospital, Singapore 119074, Singapore"],"raw_orcid":"https://orcid.org/0009-0009-5281-7171","affiliations":[{"raw_affiliation_string":"Pathology Department, National University Hospital, Singapore 119074, Singapore","institution_ids":["https://openalex.org/I4210146690"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5161315617"],"corresponding_institution_ids":["https://openalex.org/I4210146690"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"1","issue":"2","first_page":"8","last_page":"8"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10912","display_name":"Telemedicine and Telehealth Implementation","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10912","display_name":"Telemedicine and Telehealth Implementation","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.003599999938160181,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12918","display_name":"Healthcare Systems and Technology","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/telemedicine","display_name":"telemedicine","score":1.0},{"id":"https://openalex.org/keywords/cost-effectiveness","display_name":"cost-effectiveness","score":0.8980000019073486},{"id":"https://openalex.org/keywords/primary-care","display_name":"primary care","score":0.9980000257492065},{"id":"https://openalex.org/keywords/singapore-healthcare-system","display_name":"Singapore healthcare system","score":0.875},{"id":"https://openalex.org/keywords/diabetes-mellitus","display_name":"diabetes mellitus","score":0.5879999995231628},{"id":"https://openalex.org/keywords/hypertension","display_name":"hypertension","score":0.9980000257492065},{"id":"https://openalex.org/keywords/acute-myocardial-infarction","display_name":"acute myocardial infarction","score":0.996999979019165},{"id":"https://openalex.org/keywords/wound-care","display_name":"wound care","score":0.9990000128746033},{"id":"https://openalex.org/keywords/population-aging","display_name":"population aging","score":0.5189999938011169},{"id":"https://openalex.org/keywords/chronic-disease","display_name":"chronic disease","score":0.9760000109672546}],"concepts":[{"id":"https://openalex.org/C2779891985","wikidata":"https://www.wikidata.org/wiki/Q46994","display_name":"Telemedicine","level":3,"score":0.914900004863739},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.6218000054359436},{"id":"https://openalex.org/C2778137410","wikidata":"https://www.wikidata.org/wiki/Q2732820","display_name":"Government (linguistics)","level":2,"score":0.569100022315979},{"id":"https://openalex.org/C61904560","wikidata":"https://www.wikidata.org/wiki/Q1148359","display_name":"Grey literature","level":3,"score":0.5530999898910522},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.5404000282287598},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5134999752044678},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.5009999871253967},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4966999888420105},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.4368000030517578},{"id":"https://openalex.org/C189708586","wikidata":"https://www.wikidata.org/wiki/Q1504425","display_name":"Systematic review","level":3,"score":0.4357999861240387},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.42879998683929443},{"id":"https://openalex.org/C109747225","wikidata":"https://www.wikidata.org/wiki/Q815758","display_name":"Scarcity","level":2,"score":0.40790000557899475},{"id":"https://openalex.org/C13774568","wikidata":"https://www.wikidata.org/wiki/Q439112","display_name":"Population ageing","level":3,"score":0.39469999074935913},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3727000057697296},{"id":"https://openalex.org/C2776478404","wikidata":"https://www.wikidata.org/wiki/Q1105187","display_name":"Cochrane Library","level":3,"score":0.334199994802475},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3328999876976013},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.3310000002384186},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.32600000500679016},{"id":"https://openalex.org/C202645933","wikidata":"https://www.wikidata.org/wiki/Q4930","display_name":"eHealth","level":3,"score":0.3246000111103058},{"id":"https://openalex.org/C2781050511","wikidata":"https://www.wikidata.org/wiki/Q46994","display_name":"Telehealth","level":4,"score":0.30979999899864197},{"id":"https://openalex.org/C163432668","wikidata":"https://www.wikidata.org/wiki/Q623543","display_name":"Primary health care","level":3,"score":0.3093999922275543},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3091999888420105},{"id":"https://openalex.org/C19648533","wikidata":"https://www.wikidata.org/wiki/Q691640","display_name":"Evidence-based medicine","level":3,"score":0.30480000376701355},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.30250000953674316},{"id":"https://openalex.org/C2778149918","wikidata":"https://www.wikidata.org/wiki/Q3291156","display_name":"Population health","level":3,"score":0.2994999885559082},{"id":"https://openalex.org/C18762648","wikidata":"https://www.wikidata.org/wiki/Q42213","display_name":"Work (physics)","level":2,"score":0.2840000092983246},{"id":"https://openalex.org/C145642194","wikidata":"https://www.wikidata.org/wiki/Q870895","display_name":"Health informatics","level":3,"score":0.2800999879837036},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.2799000144004822},{"id":"https://openalex.org/C2780433410","wikidata":"https://www.wikidata.org/wiki/Q5276090","display_name":"Digital health","level":3,"score":0.27090001106262207},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.2615000009536743},{"id":"https://openalex.org/C121017731","wikidata":"https://www.wikidata.org/wiki/Q11661","display_name":"Information technology","level":2,"score":0.26019999384880066},{"id":"https://openalex.org/C2779231881","wikidata":"https://www.wikidata.org/wiki/Q5977147","display_name":"Medical literature","level":2,"score":0.2597000002861023},{"id":"https://openalex.org/C2776125615","wikidata":"https://www.wikidata.org/wiki/Q18391886","display_name":"Economic evaluation","level":2,"score":0.25589999556541443},{"id":"https://openalex.org/C67363961","wikidata":"https://www.wikidata.org/wiki/Q5268834","display_name":"Information and Communications Technology","level":2,"score":0.2549999952316284},{"id":"https://openalex.org/C21333345","wikidata":"https://www.wikidata.org/wiki/Q1519843","display_name":"Health technology","level":3,"score":0.2526000142097473}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.3390/dhi1020008","doi":"https://doi.org/10.3390/dhi1020008","is_oa":true,"landing_page_url":"https://doi.org/10.3390/dhi1020008","pdf_url":null,"source":{"id":"https://openalex.org/S7407057382","display_name":"Digital Health and Innovation","issn_l":"3042-9315","issn":["3042-9315"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Digital Health and Innovation","raw_type":"journal-article"},{"id":"pmh:doi:10.17605/osf.io/dnu2m","doi":null,"is_oa":true,"landing_page_url":"https://osf.io/dnu2m","pdf_url":null,"source":null,"license":"public-domain","license_id":"https://openalex.org/licenses/public-domain","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"StudyRegistration"},{"id":"doi:10.17605/osf.io/dnu2m","doi":"https://doi.org/10.17605/osf.io/dnu2m","is_oa":true,"landing_page_url":"https://doi.org/10.17605/osf.io/dnu2m","pdf_url":null,"source":{"id":"https://openalex.org/S7407050956","display_name":"Open Science Framework","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2799848540","host_organization_name":"Center for Open Science","host_organization_lineage":["https://openalex.org/I2799848540"],"host_organization_lineage_names":[],"type":"repository"},"license":"public-domain","license_id":"https://openalex.org/licenses/public-domain","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"StudyRegistration"}],"best_oa_location":{"id":"doi:10.3390/dhi1020008","doi":"https://doi.org/10.3390/dhi1020008","is_oa":true,"landing_page_url":"https://doi.org/10.3390/dhi1020008","pdf_url":null,"source":{"id":"https://openalex.org/S7407057382","display_name":"Digital Health and Innovation","issn_l":"3042-9315","issn":["3042-9315"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Digital Health and Innovation","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9907000064849854,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":29,"referenced_works":["https://openalex.org/W2101931042","https://openalex.org/W2109610344","https://openalex.org/W2156739230","https://openalex.org/W2528856486","https://openalex.org/W2557867537","https://openalex.org/W2891378911","https://openalex.org/W3003700177","https://openalex.org/W3008302958","https://openalex.org/W3020619771","https://openalex.org/W3033773203","https://openalex.org/W3034077082","https://openalex.org/W3035678763","https://openalex.org/W3036399257","https://openalex.org/W3046506727","https://openalex.org/W3092940381","https://openalex.org/W3115948230","https://openalex.org/W3168161818","https://openalex.org/W3177903656","https://openalex.org/W3185351978","https://openalex.org/W3197895364","https://openalex.org/W3202051770","https://openalex.org/W3203986037","https://openalex.org/W4200399173","https://openalex.org/W4327680927","https://openalex.org/W4387798331","https://openalex.org/W4387799050","https://openalex.org/W4395037793","https://openalex.org/W4400002434","https://openalex.org/W4412420947"],"related_works":["https://openalex.org/W3198185255","https://openalex.org/W7160322794","https://openalex.org/W4200399173","https://openalex.org/W2015842237","https://openalex.org/W104351484","https://openalex.org/W2121369253","https://openalex.org/W4391876804","https://openalex.org/W2300396413","https://openalex.org/W3027831197","https://openalex.org/W4386058618"],"abstract_inverted_index":{"Background:":[0],"Singapore\u2019s":[1,31,170],"healthcare":[2,23],"system":[3],"faces":[4],"challenges":[5,150],"of":[6,82],"a":[7,18,68,91,110],"rapidly":[8],"aging":[9],"population":[10],"and":[11,41,55,64,86,102,112,127,133,138,157,175,195,197,213,223],"rising":[12],"chronic":[13],"disease":[14],"prevalence.":[15],"Telemedicine":[16],"is":[17,215],"potentially":[19],"cost-effective":[20],"alternative":[21],"for":[22,58,160],"delivery;":[24],"however,":[25],"robust":[26],"evidence":[27,114,165],"on":[28,75,166],"cost-effectiveness":[29,83,168],"in":[30,78,145,169,191],"primary":[32,76,171,227],"care":[33,77,172,228],"sector":[34],"remains":[35],"limited.":[36],"This":[37],"scoping":[38,47],"review":[39,48],"maps":[40],"synthesizes":[42],"existing":[43],"evidence.":[44],"Methods:":[45],"A":[46],"was":[49,107],"conducted,":[50],"systematically":[51],"searching":[52],"PubMed,":[53],"MEDLINE,":[54],"Cochrane":[56],"Library":[57],"studies":[59,97,117,178],"published":[60],"between":[61],"January":[62],"2014":[63],"July":[65],"2024,":[66],"alongside":[67],"targeted":[69],"grey":[70,105],"literature":[71,106],"search.":[72],"Studies":[73],"focusing":[74],"Singapore":[79],"with":[80,201],"assessment":[81],"were":[84,88,189],"included,":[85],"data":[87,154],"extracted":[89],"using":[90,130],"predefined":[92],"form.":[93],"Results:":[94],"Seven":[95],"peer-reviewed":[96],"met":[98],"the":[99,158],"inclusion":[100],"criteria,":[101,186],"no":[103,202],"relevant":[104],"found,":[108],"indicating":[109],"limited":[111,174],"narrow":[113],"base.":[115],"The":[116],"addressed":[118],"diabetes-related":[119],"conditions":[120,212],"(four":[121],"studies),":[122],"hypertension,":[123],"acute":[124],"myocardial":[125],"infarction":[126],"wound":[128],"care,":[129],"diverse":[131,211],"platforms":[132],"delivery":[134],"methods":[135],"(synchronous,":[136],"asynchronous":[137],"mixed).":[139],"Reported":[140],"advantages":[141],"included":[142,151],"efficiency":[143],"and,":[144],"some":[146],"studies,":[147],"lower":[148],"costs;":[149],"resource":[152],"intensity,":[153],"validity":[155],"issues":[156],"need":[159],"high":[161],"individualization.":[162],"Conclusions:":[163],"Robust":[164],"telemedicine\u2019s":[167],"remain":[173],"fragmented.":[176],"Some":[177],"reported":[179],"favourable":[180],"economic":[181],"results":[182],"by":[183],"their":[184],"own":[185],"but":[187],"these":[188],"heterogeneous":[190],"design,":[192],"comparator,":[193],"perspective":[194],"quality,":[196],"none":[198],"compared":[199],"telemedicine":[200],"access":[203],"to":[204,217],"care.":[205],"Further":[206],"long-term,":[207],"comparative":[208],"research":[209],"across":[210],"populations":[214],"needed":[216],"bridge":[218],"knowledge":[219],"gaps,":[220],"guide":[221],"policy,":[222],"ensure":[224],"equitable,":[225],"sustainable":[226],"delivery.":[229]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-08-28T00:00:00"}