Cost-minimization analysis of teledermatology versus conventional care in the Brazilian National Health System.

Aims: Cost-minimization analysis (CMA) comparing the teledermatology service of the State of Santa Catarina, Brazil with the provision of conventional care, from the societal perspective. Patients & methods: All costs related to direct patient care were considered in calculation of outpatient costs. The evaluation was performed using the parameters avoided referrals and profile of hospitalizations. The economic analysis was developed through a decision tree. Results: Totally, 40% of 79,411 tests performed could be managed in primary care, avoiding commuting and expanding the patients' access. The CMA showed the teledermatology service had a cost per patient of US$196.04, and the conventional care of US$245.66. Conclusion: In this scenario, teledermatology proved to be a cost-saving alternative to conventional care, reducing commuting costs.

Lay abstract Diagnosis and treatment of skin diseases through teledermatology avoid patient referrals, improves accessibility to specialized care, as well as the skin care provided by physicians. This study compared the costs of the teledermatology service of the State of Santa Catarina, Brazil with the costs of the provision of conventional care, to check which of them was more efficient. All costs related to direct patient care were considered in the calculation of costs. Totally, 40% of 79,411 dermatological tests performed could be locally managed in primary care, avoiding commuting, and expanding the patients' access to care. The teledermatology service had a cost per patient of US$196.04, compared with the cost of conventional care of US$245.66. In this evaluation, teledermatology proved to be cheaper than conventional care, reducing commuting costs.

Indicator of access to medicines in relation to the multiple dimensions of access.

Aim: Creation of a single indicator of access to medicines. Methods: Data collection was performed with individuals who obtained their medication from either public and/or private pharmacies. A Likert scale was used to measure the importance and satisfaction in relation to various access dimensions. Results: A total of 580 individuals were interviewed. Overall, participants attributed very similar importance scores to the dimensions of access to medicines. The results of the mean score of each dimension showed a statistically significant difference according to the type of pharmacy that the participant visited. Conclusion: This developed indicator will enable a review of access to medicines, making comparisons possible as well as improving decision making about public policies in the field of Pharmaceutical Services.