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Cost-Effectiveness of Virtual Emergency Care Models: Systematic Review

Shankar R, Wang L, Ho SH, Liew MF, Kumar Gollamudi SP, Wong TC, Wong S

JMIR mHealth and uHealth, 2026

Abstract

Background: Virtual care technologies have rapidly expanded in emergency medicine, particularly following the COVID-19 pandemic. However, comprehensive economic evaluations of their cost-effectiveness remain fragmented across different clinical applications and health care settings, creating uncertainty for policymakers and health care administrators considering implementation.

Objective: This study aimed to systematically review and synthesize evidence on the cost-effectiveness of virtual emergency care models compared to traditional in-person emergency care across diverse clinical conditions, populations, and health care settings.

Methods: We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching 8 electronic databases (PubMed, Embase, Scopus, Web of Science, CINAHL, Cochrane Library, MEDLINE, and PsycINFO) from inception to February 2025. We included full economic evaluations comparing virtual emergency care interventions with usual care. Two reviewers independently screened studies, extracted data, and assessed quality using the Drummond checklist and Consensus Health Economic Criteria (CHEC) list. Evidence certainty was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Given heterogeneity in interventions and methods, we conducted a narrative synthesis by virtual care modality and clinical application.

Results: From 5817 identified…

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