Economic evaluation of interactive teledermatology compared with conventional care
Economic evaluation of interactive teledermatology compared with conventional care
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DOI：
10.1089/tmj.2006.0035
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发表时间：
2007-04-01
期刊：
影响因子：
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通讯作者：
Kvedar, Joseph C.
中科院分区：
文献类型：
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作者：
Armstrong, April W.;Dorer, David J.;Kvedar, Joseph C.
远程皮肤病提供了一种向未得到充分服务的患者提供专科护理的手段。这项研究的目的是比较交互式远程皮肤病与传统护理的成本，并从医疗保健提供者的角度评估交互式远程皮肤病在美国东北部地区是否在经济上可行。我们在楠塔基特岛的南塔基特小屋医院和马萨诸塞州波士顿的马萨诸塞州综合医院的门诊诊所研究了交互式远程皮肤病实践。这项成本最小化分析比较了互动远程皮肤科诊所和面对面皮肤科诊所的成本。单向敏感性分析考察了不同的技术成本、医生补偿或诊所空间对交互式远程皮肤病总成本的影响。我们还通过比较运营成本和报销来评估交互式远程皮肤病实践的经济可行性。在楠塔基特岛的互动式远程皮肤病诊所和在波士顿的面对面诊所的每小时总业务费用分别为274美元和346美元。三个单独的单向敏感性分析表明，如果远程皮肤科诊所的成本与传统诊所相同，远程皮肤科技术的成本可能会增加9.3倍，在远程皮肤科诊所工作的皮肤科医生可以获得高达每小时197美元的补偿，或者远程皮肤科诊所的空间成本可能达到每小时57美元。我们的分析还显示，远程皮肤科诊所的每小时报销为487美元，超过了其每小时274美元的运营成本。在偏远地区经营交互式远程皮肤病诊所的成本可能比在美国东北部附近城市中心经营传统诊所的成本要低。从医疗保健提供者的角度来看，交互式远程皮肤病可以成为向偏远地区提供皮肤病护理的经济可行的手段。
Teledermatology offers a means of providing specialist care to underserved patients. The objectives of this study were to compare the costs of interactive teledermatology with conventional care, and to evaluate from a healthcare provider perspective whether interactive teledermatology is economically viable in the northeastern region of the United States. We studied the interactive teledermatology practice at Nantucket Cottage Hospital on Nantucket Island and the ambulatory clinics at the Massachusetts General Hospital in Boston, Massachusetts. The cost-minimization analysis compared the costs of an interactive teledermatology practice with that of a face-to-face dermatology clinic. One-way sensitivity analyses examined the effect of varying the costs of technology, physician compensation, or clinic space on the overall cost of interactive teledermatology. We also assessed the economic viability of the interactive teledermatology practice by comparing the operating costs with reimbursements. The total hourly operating costs for the interactive teledermatology practice on Nantucket Island and the face-to-face clinic in Boston were $274 and $346, respectively. Three separate one-way sensitivity analyses showed that, for the cost of the teledermatology practice to equal that of the conventional clinic, the cost of teledermatology technology could increase by 9.3-fold, dermatologists working at the teledermatology practice could be compensated up to $197 an hour, or the cost of teledermatology clinic space could reach $57 an hour. Our analysis also showed that the hourly reimbursement for the teledermatology practice was $487, which exceeded its hourly operating cost of $274. The cost of operating an interactive teledermatology practice in a remote region may be less than that of a conventional clinic in a nearby urban center in the northeastern area of the United States. From a healthcare provider perspective, interactive teledermatology can be an economically viable means of providing dermatological care to remote regions.