Socioeconomic Evaluation of Pediatric Teledermatology in a Tertiary Hospital

Comprehensive evaluation of teledermatology systems includes socioeconomic assessment. In 2021, we implemented an intervention to improve the use of teledermatology in the health care area of Alicante-Hospital General. This study aimed to evaluate the socioeconomic impact of our intervention by comparing the costs and waiting times associated with teledermatology compared with conventional in-person care.

We designed a cost-effectiveness study from a health care system perspective using 2021 data. The monetary variables included the costs of the materials, application software, and training associated with teledermatology, as well as the costs of the consultations in both modalities. Our clinical outcome variable was waiting time until evaluation by a pediatric dermatologist. Using these data, we calculated an incremental cost-effectiveness ratio, then performed a sensitivity analysis. We also calculated the break-event point between the two modalities, based on the percentage of remote resolution of teleconsultations.

There were 357 teleconsultations in 2021, and we estimated 3,108 conventional referrals. The average per-patient cost of teledermatology was EUR 22.97 more than conventional care, with a cost-effectiveness ratio of EUR 0.21/day saved, which increased to EUR 0.35/day saved in the sensitivity analysis. To balance the costs of the two modalities, 84% of teleconsultations would need to be resolved remotely.

Teledermatology is more expensive than conventional in-person care but is a cost-effective option from a health care system perspective.