A break-even analysis of delivering a memory clinic by videoconferencing

Abstract

We analysed the costs of two kinds of dementia clinic. In the conventional clinic, held in a rural area, the specialist travels to the clinic from the city. In the videoconferencing clinic, patients are also seen in a rural area, but the specialist conducts the assessment by video from the city. The fixed costs common to both modalities, such as clinic infrastructure, were ignored. The total fixed cost of a monthly conventional clinic was $522 and the total fixed cost of a monthly videoconferencing clinic was $881. The additional variable cost of the specialist travelling to the conventional clinic was $2.62 per minute of the specialist's travelling time. The break-even point at which the cost of the two modalities is the same was just over two hours (138 min round trip). A sensitivity analysis showed that the break-even point was not particularly sensitive to changes in staff wages, but slightly more sensitive to the non labour costs of videoconferencing. Air travel is not an efficient alternative to travel by car. Reducing the number of clinics to six per year results in a much higher cost of running the videoconferencing service compared to the conventional service. Videoconferencing for the purpose of diagnosing dementia is both a reliable and cost effective method of health service provision when a specialist is required to drive for more than about two hours (round trip) to provide a memory disorder clinic service.

Creation of an Interprofessional Teledementia Clinic for Rural Veterans: Preliminary Data

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General Practitioners, Patients, and Care Givers Support the Use of a Telegeriatric Memory Disorder Consultation for Older Adults

“…Apart from the workforce, and the building cost, there is also the need for video conferencing equipment (a set at the local and remote site). Economic studies have shown that when a certain number of patients need to be seen, or the distance is extreme, regardless of the need for extra staff and extra equipment, it is cost effective to have a telehealth service [15]. Efficiencies established by maximising the equipment use improve the business case for telegeriatric memory disorder clinics.…”

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