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Cost analysis of telemedicine use in paediatric nephrology-the LMIC perspective
Vishnu Dev1, Aliza Mittal2, Vibha Joshi3
1Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Insights
Telemedicine consultations significantly reduce healthcare costs and travel for pediatric patients with kidney diseases, especially in remote areas. This approach offers substantial financial savings and reduces travel distance for families needing follow-up care.
Area of Science:
- Pediatric Nephrology
- Health Economics
- Digital Health
Background:
- Chronic disease management poses significant healthcare access barriers, particularly for children in rural and underserved regions.
- The COVID-19 pandemic accelerated the adoption of telemedicine, shifting healthcare delivery towards virtual consultations.
- This study specifically evaluates cost savings achieved through teleconsultations in a pediatric nephrology setting.
Purpose of the Study:
- To assess the economic benefits of utilizing telemedicine for follow-up care in pediatric nephrology.
- To quantify the cost savings and reduction in travel distance for patients and families using telehealth services.
Main Methods:
- A prospective cohort study was conducted at a tertiary care center from March 2021 to October 2022.
- Paediatric patients (29 days-18 years) with kidney-related illnesses attending telemedicine services were enrolled.
- Cost analysis was performed over a 6-month follow-up period to determine perceived cost savings for patients and families.
Main Results:
- 112 patients were enrolled, with 266 teleconsultations conducted.
- 109 patients achieved significant cost savings of INR 457,900 over 6 months, averaging INR 1577 per patient per visit.
- Patients saved a median of 2.16% of family income and reduced travel by 83,274 km collectively.
Conclusions:
- Telemedicine follow-up care demonstrably reduces financial burdens and travel requirements for pediatric nephrology patients.
- The findings highlight the potential of telemedicine to improve healthcare accessibility and affordability in remote or underserved populations.
Background:
The overall cost of managing chronic diseases is a significant barrier to accessing complete and timely healthcare, especially in rural and geographically isolated areas. This cost disparity becomes more pronounced in the case of children and more so in under-resourced regions of the world. In the era of COVID-19, as the need for physical distancing increased, there was a transition in approach to healthcare provision to telemedicine consultations. This study evaluates the cost saving using teleconsultations in a paediatric nephrology clinic.
Methods:
This prospective cohort study was conducted at AIIMS Jodhpur, a tertiary care centre in western Rajasthan from March 2021 to October 2022. All consecutive paediatric (29 days-18 years) patients attending telemedicine services for kidney-related illness were enrolled. Basic demographic details were collected. Cost analysis was done after 6 months, regarding perceived cost savings for the patient and family by using telehealth for follow-up during 6 months starting from enrolment.
Results:
A total of 112 patients were enrolled; 266 teleconsultations attended; 109 patients who could be followed up saved INR 457,900 during 6 months of follow-up. The average cost saving was INR - 1577/patient/visit. Patients saved 4.99% of the family income (median 2.16% (IQR 0.66-5.5)). The highest expenditure per visit was incurred for food and transport. The median distance from the residence to the clinic was 122.5 km (IQR 30-250). Over the 6-month study period, patients saved a travel distance of 83,274 km (743 km/patient).
Conclusions:
The use of telemedicine as a follow-up method helps save significant costs and distances travelled by patients. A higher-resolution version of the Graphical abstract is available as Supplementary information.
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