Cost and Potential Savings of Electronic Consultation and Its Relationship with Reduction in Atmospheric Pollution

Daniel Rey Aldana,Sergio Cinza Sanjurjo,Francisco Gude Sampedro,Pilar Mazón Ramos,Belén Álvarez Álvarez,José R González-Juanatey,Manuel Portela Romero,Rosa Agra Bermejo,Francisco Reyes Santias

doi:10.3390/su132212436

Abstract

Background: Telemedicine has been incorporated into daily clinical practice. The purpose of this paper is to evaluate the economic impact of electronic consultation as a means of referring patients between Primary Care (PC) services and the referral Cardiology Service (CS) of a tertiary hospital, in particular, the cost of reduced air pollution. Methods: The direct and indirect costs associated with all the interconsultations between PC and a CS of a tertiary hospital were analyzed under a universal single act model versus a prior e-consultation model that selected patients who would later attend the single-act consultation. The cost of pollution from private motor vehicle travel by road has been analyzed with a Cobb–Douglas cost function. Results: The total cost per patient, including the costs associated with death, represented a saving in the model with e-consultation of 25.6%. The economic value for the reduction of contamination would be EUR 12.86 per patient. Conclusions: The introduction of e-consultation in the outpatient management of patients referred from PC to a CS, helps to reduce direct and indirect costs for the patient and the Health Care System. The cost of pollution associated with the trips explains the total cost to a greater extent, except for the first face-to-face consultation.

Highlights

It has been observed that telemedicine systems can be effective in reducing total mortality, as in the clinical trial Telemonitoring in the Management of Heart Failure study [2], and cost-effective, when the assessment can be made through the information available in the electronic medical record [3,4]
Sustainability 2021, 13, 12436 (CS) services are one of the places where telemedicine can have a greater application and utility, especially in view of the need for a rapid response and adequate to the consultation generated from Primary Care (PC), where it is possible to resolve, in a high percentage of cases, the demand for care through information and complementary tests performed on the patient at another level of care [5]
Between 2010 and 2012, 12,182 (29.4%) patients were referred to the SC, all assessed in person in a single-act consultation

Summary

Introduction

It has been observed that telemedicine systems can be effective in reducing total mortality, as in the clinical trial Telemonitoring in the Management of Heart Failure study [2], and cost-effective, when the assessment can be made through the information available in the electronic medical record [3,4]. The purpose of this paper is to evaluate the economic impact of electronic consultation as a means of referring patients between Primary Care (PC) services and the referral Cardiology Service (CS) of a tertiary hospital, in particular, the cost of reduced air pollution. The economic value for the reduction of contamination would be EUR 12.86 per patient

Objectives

Methods

Results

Discussion

Conclusion