A Cost-Minimization Analysis of a Medical Record-based, Store and Forward and Provider-to-provider Telemedicine Compared to Usual Care in Catalonia: More Agile and Efficient, Especially for Users

Francesc López Seguí, Jordi Franch Parella, Xavier Gironès García, Jacobo Mendioroz Peña, Francesc García Cuyàs, Cristina Adroher Mas, Anna García-Altés, Josep Vidal-Alaball, Francesc López Seguí, Jordi Franch Parella, Xavier Gironès García, Jacobo Mendioroz Peña, Francesc García Cuyàs, Cristina Adroher Mas, Anna García-Altés, Josep Vidal-Alaball

Abstract

Background: Telemedicine (interconsultation between primary and hospital care teams) has been operating in the counties of Central Catalonia Bages, Moianès and Berguedà since 2011, specializing in teledermatology, teleulcers, teleophthalmology and teleaudiometries. For the period until the end of 2019, a total of 52,198 visits were recorded.

Objective: To analyze the differential costs between telemedicine and usual care in a semi-urban environment.

Methodology: A cost-minimization evaluation, including direct and indirect costs from a societal perspective, distinguishing healthcare and user's costs, was carried out over a three-month period.

Results: Telemedicine saved € 780,397 over the period analyzed. A differential cost favorable to telemedicine of about € 15 per visit was observed, with the patient being the largest beneficiary of this saving (by 85%) in terms of shorter waiting times and travel costs. From the healthcare system perspective, moving the time spent in a hospital care consultation to primary care is efficient in terms of the total time devoted per patient. In social terms and in this context, telemedicine is more efficient than usual care.

Conclusion: Allowing users to save time in terms of consultation and travel is the main driver of interconsultation between primary and hospital care savings in a semi-urban context. The telemedicine service is also economically favorable for the healthcare system, enabling it to provide a more agile service, which also benefits healthcare professionals.

Keywords: cost analysis; economic analysis; health technology assessment; provider-to-provider telemedicine; telehealth.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient flow: telemedicine vs. usual care.
Figure 2
Figure 2
Origin and destination (either Hospital Sant Bernabé in Berga or Althaia Xarxa Assistencial Universitària in Manresa) of telemedicine visits avoided. The thickness of the line corresponds to the number of journeys saved.

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