An economic evaluation of a telehealth network in British Columbia

Abstract

We carried out an economic evaluation of the northernmost five sites of the British Columbia telehealth network. The videoconferencing network links health-care facilities in 12 communities with Vancouver, for clinical consultations, administrative meetings and educational sessions. The economic evaluation was based on the netcost criterion (i.e. cost of telehealth minus travel costs avoided). Cost and utilization data were obtained from client interviews and log data compiled between September 2001 and January 2003. The results showed that the subnetwork of five sites was not only cost reducing, but also cost-effective. Travel costs for administrative meetings were reduced by $724,457/annum and were greater than the annual fixed and variable costs of all the telehealth sessions ($553,740). A sensitivity analysis was conducted on six parameters: amortization period, opportunity cost of capital, operating cost of a telehealth session (by type of session), number of telehealth sessions, travel time and the opportunity cost of travel time. The study suggests that the cost-effectiveness of telehealth to remote areas will increase over time as the cost of equipment continues to fall, as network connections become cheaper and as utilization rates rise.

The views of health-care personnel about video consultation prior to implementation in primary health care in rural areas

“…Schaafsma et al . (2007) described that VC affects patient care directly with the increased availability to medical facilities and indirectly through education of health-care professionals. Another advantage with VC is that the patient does not need to be called for follow-ups, and it is also positive that the GP can hear and discuss the specialist physicians’ treatment advice right away.…”

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

“…In addition, most authors calculate and include the avoided accommodation and other daily expenses. [39][40][41][42] A patient seeking diagnosis and=or treatment for a particular condition may have to forgo wages, leisure time, or classroom time to travel to a referral facility. Most studies indicate that telemedicine decreases the travel time to appointment sites.…”

“…The same approach can be used for leisure time using the rate of pay as the opportunity cost of leisure. Travel costs avoided are usually calculated using easily accessible information on mileage charges, 7,28,29,39,41 air fares, 8,39,40 overnight accommodation, and estimates of daily additional expenses (taxi, meals, etc.) at the location of the referral facility.…”

The added value of thorough economic evaluation of telemedicine networks

“…Analysis of these papers revealed a similar trend, with the range of costs remaining the same as before. Eight studies were simply cost minimisation analyses [11][12][13][14][15][16][17][18], six were costeffectiveness analyses [19][20][21][22][23][24], one was a cost-utility analysis [25], and one was a cost-benefit analysis [26]. We noticed a tendency to use different points of view: society, patients, or payers.…”