Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jul 02, 2026)

Date Submitted: Feb 2, 2026

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Cost-effectiveness of digital health in primary care: a systematic review

  • Sandra Stern; 
  • Anna Johansson; 
  • Evalill Nilsson; 
  • Lina Nilsson

ABSTRACT

Background:

Digital health has rapidly expanded, accelerated by the COVID-19 pandemic, and is now widely used for consultations, disease management, and efficiency improvements in primary care. While it is considered clinically effective and potentially cost-effective, evidence on economic impact remains limited. Previous reviews have been condition-specific, highlighting the need for an updated systematic review focused on cost-effectiveness of digital health within primary care.

Objective:

The aim of this systematic review is to summarize and investigate the cost-effectiveness of digital health among adult primary care patients.

Methods:

A comprehensive literature search was conducted using the PICO framework. Both partial and full economic evaluations were included. Search results are presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Methodological quality was assessed using the Joanna Briggs Institute Checklist for Economic Evaluations.

Results:

The search identified 4,091 results, of which 393 were selected for title and abstract screening and 47 studies were included in the review.

Conclusions:

The findings indicate that digital health is generally cost-effective, particularly within mental health, where improved outcomes and reduced costs are frequently reported. The evidence base is primarily informed by trial-based economic evaluations conducted from a healthcare perspective. However, substantial methodological heterogeneity and lack of standardization remain significant challenges. Clinical Trial: PROSPERO registration no. CRD42025644904


 Citation

Please cite as:

Stern S, Johansson A, Nilsson E, Nilsson L

Cost-effectiveness of digital health in primary care: a systematic review

JMIR Preprints. 02/02/2026:92718

DOI: 10.2196/preprints.92718

URL: https://preprints.jmir.org/preprint/92718

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.