A cost-minimization analysis of the societal costs of realtime teledermatology compared with conventional care: results from a randomized controlled trial in New Zealand

Abstract

A randomized controlled trial was carried out to measure the societal costs of realtime teledermatology compared with those of conventional hospital care in New Zealand. Two rural health centres were linked to a specialist hospital via ISDN at 128 kbit/s. Over 10 months, 203 patients were referred for a specialist dermatological consultation and 26 were followed up, giving a total of 229 consultations. Fifty-four per cent were randomized to the teledermatology consultation and 46% to the conventional hospital consultation. A cost-minimization analysis was used to calculate the total costs of both types of dermatological consultation. The total cost of the 123 teledermatology consultations was NZ$34,346 and the total cost of the 106 conventional hospital consultations was NZ$30,081. The average societal cost of the teledermatology consultation was therefore NZ$279.23 compared with NZ$283.79 for the conventional hospital consultation. The marginal cost of seeing an additional patient was NZ$135 via teledermatology and NZ$284 via conventional hospital appointment. From a societal viewpoint, and assuming an equal outcome, teledermatology was a more cost-efficient use of resources than conventional hospital care.

Teledermatology for diagnosis and management of skin conditions: A systematic review

“…Cost data were reported in 3 studies involving SAF teledermatology, 72-74 6 studies of LI teledermatology, 69,70,[75][76][77][78] and one study that included both SAF and LI teledermatology 79 (Table X; available online at http://www.eblue.org). Because of differences in factors included in cost assessments and the various perspectives (societal, health service, or patient), it was difficult to summarize these findings.…”

Teledermatology: Outcomes and Economic Considerations

“…For example, researchers in New Zealand found that, compared to a clinic visit, the use of LI teledermatology saved patients an average of 3.45 hours of time, primarily due to reduced traveling time (Oakley et al, 2000). However, LI teledermatology does not necessarily reduce consult time for the dermatologist (Loane et al, 1999(Loane et al, , 2001bOakley et al, 2000).…”

“…While some studies have shown LI teledermatology to be cost-effective, others suggested that it may be more costly than conventional care. In a cost-minimization analysis from a societal perspective, authors from New Zealand found that teledermatology consultations using LI technology appeared less costly than that of face-to-face care, especially when patients have longer travel distances (Loane et al, 2001b). In another costminimization study of LI teledermatology in the U.S., investigators found that consultative teledermatology using LI technology also appears to be less costly than face-to-face care from a provider perspective (Armstrong et al, 2007).…”

Teledermatology: Just Cool or a Real Tool?

“…From a societal viewpoint, and assuming an equal outcome, teledermatology seems to be a more cost-effective use of resources than conventional hospital care [6]. …”