An economic analysis of the EHAS telemedicine system in Alto Amazonas

Abstract

Telemedicine systems providing voice communication and email by radio were installed at seven health centres (HCs) and 32 health posts (HPs) in the Alto Amazonas province of Peru during 2001. A cost analysis was performed to estimate the net effect on direct resource consumption from the perspective of society. Prior to the availability of the EHAS telemedicine system, there was a mean of 11.1 urgent patient referrals per year from the HPs and 14.0 referrals per year from the HCs. After the implementation of telemedicine, patient referrals fell to 2.5 per year from the HPs (P = 0.03) and to 8.4 per year from the HCs (P = 0.17). The net economic effect of the telemedicine programme over a four-year period was clearly positive, amounting to annual net savings of US$320,126 (using a 5% discounting rate). A one-way sensitivity analysis using a range of values for the discounting rate, and the number of urgent referrals, confirms that the programme was efficient (i.e. it made net financial savings) in all cases. From the restricted budgetary perspective of the health network, the results also demonstrate that the additional operational costs (telephone and maintenance) introduced by the telemedicine system were lower than the direct cost-savings produced for the health-care network.

Economic Evaluation of Telemedicine: Review of the Literature and Research Guidelines for Benefit–Cost Analysis

“…It is common in the economic evaluation of telemedicine to study the effect of these programs in avoiding excessive and=or unnecessary use of health services. Most studies agree that telemedicine reduces the use of health services such as physician office visits, 49 emergency department visits, 49-51 number of hospitalizations, 51,52 hospital readmissions, 50,53 home visits, 52 length of hospital stay, 53 use of ambulance services, 47 number of referrals, 31 duration of consultations, number of laboratory tests, and avoided transfers=evacuations. 54,55 Medication compliance and faster=accurate diagnosis and treatment, which were mentioned above as means for health improvement, can also have benefits through the reduction of healthcare utilization.…”

“…A reduction in travel time or home visits has the additional benefit of increasing staff productivity. Travel time is calculated by estimating the average time that it takes the staff (e.g., via air, private vehicle, bus) to travel from the referral facility to the community (see, for example, Martínez et al 31 ).…”

Evaluación de programas de salud electrónica en el Perú: enfoque multidisciplinario y perspectivas actuales

“…Asimismo, un beneficio relacionado a la evaluación de los programas de eSalud es la disminución de los costos de ejecución. Por ejemplo, se encontró una evaluación económica de un proyecto de telemedicina (EHAS-Alto Amazonas), donde se estimó el efecto económico neto sobre un periodo de cuatro años, con una conclusión claramente positiva, cuantificando un ahorro neto anual de USD 320 126 (20) . Idealmente, cada proyecto, independientemente del área que comprenda, debería reportar sus resultados.…”

Experiences in Volunteer Dynamics, Inter-organizational Collaboration and Leadership for the Purpose of Deploying Telemedicine Solutions in Remote Areas in Developing Nations

“…Studies of the cost effectiveness of telehealth in rural areas have already evaluated the economic benefit of a wireless telehealth system in the Alto Amazon region of Peru and found positive economic benefits [20]. The main cost saving was a reduction in the travel costs of health care personnel and a reduction in the costs of urgent referrals from health centers and health posts to local hospitals.…”

“…The main cost saving was a reduction in the travel costs of health care personnel and a reduction in the costs of urgent referrals from health centers and health posts to local hospitals. These costs savings outweighed the capital and operating costs of the system from the second year of operation onwards [20].…”