In North America, Australia and Europe, many cable operators have already introduced cable telephone service, which operates just like existing fixed line operators. This service involves installing a special telephone interface at the customer's premises that converts the analog signals from the customer's in-home wiring into a digital signal, which is then sent on the local loop (replacing the analog last mile, or plain old telephone service (POTS)) to the company's switching center, where it is connected to the public switched telephone network (PSTN). The biggest obstacle to cable telephone service is the need for nearly 100% reliable service for emergency calls. One of the standards available for digital cable telephony, PacketCable, seems to be the most promising and able to work with the quality of service (QOS) demands of traditional analog plain old telephone service (POTS) service. The biggest advantage to digital cable telephone service is similar to the advantage of digital cable, namely that data can be compressed, resulting in much less bandwidth used than a dedicated analog circuit-switched service. Other advantages include better voice quality and integration to a Voice over Internet Protocol (VoIP) network providing cheap or unlimited nationwide and international calling. In many cases, digital cable telephone service is separate from cable modem service being offered by many cable companies and does not rely on Internet Protocol (IP) traffic or the Internet.
The question of "when does it make sense?" can easily be rephrased as "how much money can I save?" and one of the biggest factors will be the price difference between combined internet and TV service or just internet. These are also the options that vary the most widely based on where you live, and the availability of promotions or contracts that can keep prices down for a short time.