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A cost minimisation analysis in teledermatology: model-based approach.
Nina Eminović1, Marcel G Dijkgraaf, Rosanne M Berghout
1Department of Medical Informatics, Academic Medical Center-University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands. n.eminovic@gmail.com
Store-and-forward teledermatology may not be cost-saving for all dermatology referrals. Cost savings are possible when patients travel long distances or when teledermatology prevents a significant number of in-person consultations.
Area of Science:
- Health Economics
- Dermatology
- Telemedicine
Background:
- Store-and-forward teledermatology is gaining popularity.
- Evidence on its efficiency and cost-effectiveness is limited.
- This study builds upon the PERFECT D Trial (ISRCTN57478950).
Purpose of the Study:
- To assess the cost-effectiveness of store-and-forward teledermatology from a societal perspective.
- To identify conditions under which teledermatology can reduce healthcare costs.
Main Methods:
- A cost minimization study using a model-based approach.
- Compared costs of teledermatology versus conventional dermatology care.
- Utilized Monte Carlo simulation and sensitivity analyses for uncertainty and scenario evaluations.
Main Results:
- Mean costs: Teledermatology €387 (95%CI, 281-502.5) vs. Conventional €354 (95%CI, 228-484).
- Mean difference: €32.5 (95%CI, -29.0 to 74.7).
- Savings achieved if dermatologist distance >= 75 km or >= 37% consultations prevented.
Conclusions:
- Teledermatology has an 11% probability of being cost-saving for all dermatology referrals.
- Cost savings are contingent on preventing live consultations.
- Targeted application in specific scenarios is recommended for cost-effectiveness.
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