Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

A cost minimisation analysis of an asynchronous teledermatology service in the catalan central region

47 views

Published on

WONCA Krakow 2018

Published in: Health & Medicine
  • The #1 Woodworking Resource With Over 16,000 Plans, Download 50 FREE Plans...  http://ishbv.com/tedsplans/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Get access to 16,000 woodworking plans, Download 50 FREE Plans... ◆◆◆ http://ishbv.com/tedsplans/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Want to preview some of our plans? You can get 50 Woodworking Plans and a 440-Page "The Art of Woodworking" Book... Absolutely FREE ➤➤ http://ishbv.com/tedsplans/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

A cost minimisation analysis of an asynchronous teledermatology service in the catalan central region

  1. 1. gencat.cat/ics A cost minimisation analysis of an asynchronous teledermatology service in the Catalan central region Josep Vidal-Alaball Primary Care Physician Catalonia
  2. 2. gencat.cat/ics Índex 231/08/2018  Telemedicine  Study  Results  Discussion  Questions
  3. 3. gencat.cat/ics Telemedicine 331/08/2018 Telemedicine has been defined as the “medicine practiced at a distance” According to the timing of the information transmitted, there are 3 main types of telemedicine: 1. Store-and-forward or asynchronous (not real-time) telemedicine 2. Videoconference or synchronous (real-time time) telemedicine 3. Remote patient monitoring.
  4. 4. gencat.cat/ics Telemedicine 431/08/2018 In three counties of Central Catalonia asynchronous telemedicine services between primary care and local hospitals have been developed In the teledermatology program in operation since 2010, primary care professionals take photographs of dermatological lesions and attach them into the patient's computerised medical records together with a brief clinical account • The use of electronic medical records guaranties confidentiality of images, since it avoids potentially insecure electronic storage and e-mail.
  5. 5. gencat.cat/ics Telemedicine 531/08/2018 The dermatologists at the hospital access the patient's medical history, review the images and propose a treatment or plan of action to follow The primary care professionals review the proposal and make a phone call to the patient to explain the results of the consultation The whole process takes usually less than 5 working days.
  6. 6. gencat.cat/ics Telemedicine 631/08/2018 If the dermatologists consider it convenient, can ask the primary care professionals to refer the patient for a face-to-face visit This program has had considerable success in reducing dermatology waiting lists, from a mean of 30 days (95% CI: 29-32) to a mean of 16 days (95% CI: 15-17) after its implementation. J. Vidal-Alaball, D. Álamo-Junquera, S. López-Aguilá, and García-Altés, “Evaluación del impacto de la teledermatología en la disminución de la lista de espera en la comarca del Bages (2009-2012).,” Aten Primaria, pp. 9–10, 2014.
  7. 7. gencat.cat/ics Cost minimisation analysis 731/08/2018 The ain objective of this study was to assess the economic impact of asynchronous telemedicine services in the Catalan central region comparing the cost of teledermatology with the cost of traditional outpatient consultations A cost minimisation analysis comparing teledermatology with traditional dermatology consultations in the county of Bages was performed measuring direct and indirect costs of and the cost of the visits saved.
  8. 8. gencat.cat/ics Results 831/08/2018 During 2016, 5,606 patients were referred to the teledermatology service, of which 1,104 patients were further referred to traditional outpatient consultation (within the next 3 months). Consequently, the teledermatology service saved a total of 4,502 face-to- face visits Cost of primary care physicians and dermatologists: Service Primary Care Dermatology Initial consultations Telephone calls Face-to-face Teledermatology N. Visits min 45020 9004 67530 22510 4502 hours 750,3 150,1 1125,5 375,2 Cost 17333 3467 23073 7691
  9. 9. gencat.cat/ics Cost minimisation analysis 931/08/2018 Cost of time lost (patient) by primary care centre: Time adding Total time Time spent consultation with consultationin Primary TeleDM in hospital to hospital care visits Referrals Saved visits (25 mins) Minutes hours (20 mins) hours CAP MANRESA 2 1067 227 840 34 28560 476 16800 280,0 CAP SAGRADA FAMILIA 828 178 650 28 18200 303,3 13000 216,7 CAP SALLENT 376 53 323 40 12920 215,3 6460 107,7 CAP SANT FRUITÓS 294 64 230 32 7360 122,7 4600 76,7 CAP SANT JOAN DE VILATORRADA 494 105 389 36 14004 233,4 7780 129,7 CAP SANT VICENÇ DE CASTELLET 345 69 276 37 10212 170,2 5520 92,0 CAP SANTPEDOR 286 59 227 36 8172 136,2 4540 75,7 Other 1916 349 1567 1183 522,7 Total 5606 1104 4502 Total Time 2840 1500,7 Total € 60208 21815
  10. 10. gencat.cat/ics Results 1031/08/2018 Patients would have travelled a total of 49,684 km if they had attended traditional outpatient consultations instead of using teledermatology. This amounts to 12,421 € in petrol Primary Care centre Saved visits Km to Hospital Saved Km Cost Km saved CAP MANRESA 2 840 2,8 2352 588 CAP SAGRADA FAMILIA 650 1,2 780 195 CAP SALLENT 323 15 4845 1211 CAP SANT FRUITÓS 230 6 1380 345 CAP SANT JOAN DE VILATORRADA 389 9 3501 875 CAP SANT VICENÇ DE CASTELLET 276 9,2 2539 635 CAP SANTPEDOR 227 9,2 2088 522 Other 1567 32199 8050 Total 4502 49684 12421
  11. 11. gencat.cat/ics Results 1131/08/2018 The estimated added costs of the teledermatology service during 2016 were of 61,870 €. For the same period, the estimated costs of the traditional outpatient services if all patients had been referred to face-to-face visits would have been of 113,034€. This represents savings of 51,164 € during 2016 Since in 2016 a total of 4,502 patients used these services, the savings amount to 11.4 € per patient visited. Cost per year in € Teledermatology Dermatology Difference Equipment 1565 0 1565 Primary care staff 20799 17332 3467 Hospital staff 7691 23073 -15382 Subtotal 30055 40405 -10350 Society Time 31815 60208 -28393 Petrol 12421 -12421 TOTAL 61870 113034 -51164
  12. 12. gencat.cat/ics Discussion 1231/08/2018 In the analysis, societal costs emerge as the variable with the biggest impact on our calculations; savings due to teledermatology amounted to 40,814 € per annum The main savings derived from time saved by not travelling to the hospital When removing societal costs, teledermatology savings amounted to 10,350 € in 2016 Staff costs were also significant, particularly in the hospital, since the use of teledermatology saved considerable time to dermatology consultants.
  13. 13. gencat.cat/ics Discussion 1331/08/2018 In primary care, staff costs increased slightly with teledermatology because primary care physicians were required to phone patients to explain the results The setting of this study is the county of Bages. However, we believe that the data are extrapolable to the other regions of Catalonia. We calculated that the savings for the whole population of Catalonia (7,519,000 inhabitants) would amount to 2,085,061 € Conclusions: Using a teledermatology service instead of face-to-face dermatology consultations could save 11.4 € per patient visited.
  14. 14. gencat.cat/ics 14
  15. 15. gencat.cat/ics gencat.cat/ics Information/contact: jvidal.cc.ics@gencat.cat http://www.slideshare.net/jvalaball Twitter/Instagram: @jvalaball

×