A cost-minimization analysis comparing teledermoscopy and face-to-face evaluations of suspicious skin lesions in Southern Denmark.

Abstract

Skin cancers are common in European populations and generate considerable costs. In Denmark, patients with suspicious skin lesions will usually consult their general practitioner who may refer the patient to a dermatologist or plastic surgeon if necessary. However, it is also possible for the general practitioner to take and send dermoscopic and macroscopic photographs of the suspicious skin lesion for evaluation by a dermatologist, so-called teledermoscopy. This study aims to calculate and compare costs of teledermoscopy and standard care in the form of face-to-face evaluation by a dermatologist of suspicious skin lesions referred by general practitioners in the Region of Southern Denmark. A cost-minimization study was performed. Investment costs, costs in general practice, hospital-associated costs and patient costs were included to calculate the average cost per patient episode. The overall cost of teledermoscopy was €17.2-€23.1 higher than that of standard care. However, hospital-associated costs and patient costs were reduced. The total cost of teledermoscopy was slightly higher than the cost of standard care. Sensitivity analyses indicated that the number of preventable face-to-face evaluations and the distance to the dermatologist were the two factors that influenced costs the most.