An economic cost analysis of an expanding, multi-state behavioural telehealth intervention.
J Telemed Telecare
; 25(6): 353-364, 2019 Jul.
Article
en En
| MEDLINE
| ID: mdl-29754561
ABSTRACT
INTRODUCTION:
In this paper the economic costs associated with a growing, multi-state telepsychiatry intervention serving rural American Indian/Alaska Native populations were compared to costs of travelling to provide/receive in-person treatment.METHODS:
Telepsychiatry costs were calculated using administrative, information-technology, equipment and technology components, and were compared to travel cost models. Both a patient travel and a psychiatrist travel model were estimated utilising ArcGIS software and unit costs gathered from literature and government sources. Cost structure and sensitivity analysis was also calculated by varying modeling parameters and assumptions. RESULTS ANDDISCUSSION:
It is estimated that per-session costs were $93.90, $183.34, and $268.23 for telemedicine, provider-travel, and patient-travel, respectively. Restricting the analysis to satellite locations with a larger number of visits reduced telemedicine per-patient encounter costs (50 or more visits $83.52; 100 or more visits $80.41; and 150 or more visits $76.25). The estimated cost efficiencies of telemedicine were more evident for highly rural communities. Finally, we found that a multi-state centre was cheaper than each state operating independently.CONCLUSIONS:
Consistent with previous research, this study provides additional evidence of the economic efficiency associated with telemedicine interventions for rural American Indian/Alaska Native populations. Our results suggest that there are economies of scale in providing behavioural telemedicine and that bigger, multi-state telemedicine centres have lower overall costs compared to smaller, state-level centres. Additionally, results suggest that telemedicine structures with a higher number of per-satellite patient encounters have lower costs, and telemedicine centres delivering care to highly rural populations produce greater economic benefits.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_desigualdade_iniquidade
/
1_financiamento_saude
Asunto principal:
Población Rural
/
Viaje
/
Indígenas Norteamericanos
/
Telemedicina
/
Servicios de Salud del Indígena
/
Servicios de Salud Mental
Tipo de estudio:
Diagnostic_studies
/
Health_economic_evaluation
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
Límite:
Humans
Idioma:
En
Revista:
J Telemed Telecare
Asunto de la revista:
INFORMATICA MEDICA
/
SERVICOS DE SAUDE
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos