A cost study of teleconsultation for primary-care ophthalmology and dermatology

Abstract

Teleconsultations were performed between a health centre in a small Finnish town and a university hospital 55 km away. Telemedicine consultations were carried out with a total of 42 patients suffering from various eye and skin disorders. We evaluated the costs of the teleconsultations in the health centre and the conventional alternative of the patient travelling to the hospital. The cost of conventional consultations, which was not affected by the patient workload, was EU126 per patient for ophthalmology and EU143 per patient for dermatology. The cost of the teleconsultations per patient decreased as the number of patients increased. There were cost savings in relation to teleconsultations when the annual numbers of patients were more than 110 in ophthalmology and 92 in dermatology. Benefits and savings achieved through teleconsultations mainly consisted of reduced transportation costs and reduced paperwork both at the health centre and at the university hospital, as well as time savings for the patient. Another important benefit was improved medical education. The present study shows that teleconsultations can be performed in a cost-effective way in a relatively small health centre.

Review of economic evaluations of teleophthalmology as a screening strategy for chronic eye disease in adults

“…Teleophthalmology was less costly at a workload of 128 patients, suggesting an increased number of teleophthalmology consultations, coupled with decrease in cost of telecommunications and equipment will increase savings. Lamminen et al 36 estimated teleophthalmology fixed costs at €9760 and variable costs at €37.6 compared with €126 for traditional consultation. The breakeven point was ≥110 teleophthalmology consultations annually.…”

Teledermatology research review

“…One additional study, not included in the table, used economic modeling techniques. 41 The authors reported models that indicated real-time teledermatology could be costsaving, with cost savings being largely dependent on consult volume.…”

Economic Analysis of Telemedicine and the Teledermatology Paradigm

“…[6][7][8] The literature on realtime interactive teledermatology has run the gamut from teledermatology being a cost-saving strategy to one that incurs greater costs. [12][13][14][15][16][17][18] A notable deficit in the real-time interactive literature is a true cost-effectiveness analysis.…”

“…The conclusions vary from teledermatology being a cost-saving strategy, to a cost-neutral strategy, to one that incurs greater costs. [12][13][14][15][16][17][18] …”