A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective

Loane, MA, Bloomer, SE, Corbett, R, Eedy, DJ, Evans, C, Hicks, N, Jacklin, P, Lotery, HE, Mathews, C, Paisley, J, Reid, P, Steele, K and Wootton, R (2001) A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective. Journal of Telemedicine And Telecare, 7 2: 108-118.


Author Loane, MA
Bloomer, SE
Corbett, R
Eedy, DJ
Evans, C
Hicks, N
Jacklin, P
Lotery, HE
Mathews, C
Paisley, J
Reid, P
Steele, K
Wootton, R
Title A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective
Journal name Journal of Telemedicine And Telecare   Check publisher's open access policy
Publication date 2001
Sub-type Article
DOI 10.1258/1357633011936246
Volume number 7
Issue number 2
ISSN 1357-633X
Start page 108
End page 118
Total pages 11
Editor R Wootton
Place of publication London
Publisher Royal Society of Medicine
Collection year 2001
Language eng
Subject C1
329999 Medical and Health Sciences not elsewhere classified
730199 Clinical health not specific to particular organs, diseases and conditions
Abstract A randomized controlled trial was carried out to measure the cost-effectiveness of realtime teledermatology compared with conventional outpatient dermatology care for patients from urban and rural areas. One urban and one rural health centre were linked to a regional hospital in Northern Ireland by ISDN at 128 kbit/s. Over two years, 274 patients required a hospital outpatient dermatology referral -126 patients (46%) were randomized to a telemedicine consultation and 148 (54%) to a conventional hospital outpatient consultation. Of those seen by telemedicine, 61% were registered with an urban practice, compared with 71% of those seen conventionally. The clinical outcomes of the two types of consultation were similar - almost half the patients were managed after a single consultation with the dermatologist. The observed marginal cost per patient of the initial realtime teledermatology consultation was f52.85 for those in urban areas and f59.93 per patient for those from rural areas. The observed marginal cost of the initial conventional consultation was f47.13 for urban patients and f48.77 for rural patients. The total observed costs of teledermatology were higher than the costs of conventional care in both urban and rural areas, mainly because of the fixed equipment costs. Sensitivity analysis using a real-world scenario showed that in urban areas the average costs of the telemedicine and conventional consultations were about equal, while in rural areas the average cost of the telemedicine consultation was less than that of the conventional consultation.
Keyword Health Care Sciences & Services
Cost-benefit-analysis
Northern-ireland
Multicenter Teledermatology
Patient Satisfaction
Diagnostic-accuracy
New-zealand
Telemedicine
Dermatology
Teleconsultations
Q-Index Code C1

Document type: Journal Article
Sub-type: Article
Collection: Centre for Online Health Publications
 
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Created: Tue, 14 Aug 2007, 16:06:06 EST