Telemedicine in Primary Care: A Scoping Review of Cost-Effectiveness in Singapore

Background: Singapore’s healthcare system faces challenges of a rapidly aging population and rising chronic disease prevalence. Telemedicine is a potentially cost-effective alternative for healthcare delivery; however, robust evidence on cost-effectiveness in Singapore’s primary care sector remains limited. This scoping review maps and synthesizes existing evidence. Methods: A scoping review was conducted, systematically searching PubMed, MEDLINE, and Cochrane Library for studies published between January 2014 and July 2024, alongside a targeted grey literature search. Studies focusing on primary care in Singapore with assessment of cost-effectiveness were included, and data were extracted using a predefined form. Results: Seven peer-reviewed studies met the inclusion criteria, and no relevant grey literature was found, indicating a limited and narrow evidence base. The studies addressed diabetes-related conditions (four studies), hypertension, acute myocardial infarction and wound care, using diverse platforms and delivery methods (synchronous, asynchronous and mixed). Reported advantages included efficiency and, in some studies, lower costs; challenges included resource intensity, data validity issues and the need for high individualization. Conclusions: Robust evidence on telemedicine’s cost-effectiveness in Singapore’s primary care remain limited and fragmented. Some studies reported favourable economic results by their own criteria, but these were heterogeneous in design, comparator, perspective and quality, and none compared telemedicine with no access to care. Further long-term, comparative research across diverse conditions and populations is needed to bridge knowledge gaps, guide policy, and ensure equitable, sustainable primary care delivery.