Abstract
Background: Neuro-surgical emergencies are serious (long-term disability and high mortality) and costly to the national health services. Tele-medicine intervention can facilitate to reduce this gap. Our study aims to evaluate the cost-effectiveness of tele-video-consultation intervention for the management of neuro-surgical emergencies in the general hospitals.Methods: We retrieved health service data from the tele-consultation service, online tele-medicine database portal and hospital patient registry, between January 2009 and December 2012 and evaluated cost-effectiveness of the tele-video-consultation intervention from an Italian National Health Service perspective.Results: Seventy-five percent of the tele-consultations were completed within 15 min and 90% within 30 min. The average costs were €2,326 in the intervention group and €4,173 in the care as usual group. The intervention avoided 73% potential transfer (saving of 139,916 km travel distance during a 4-years period). The incremental cost-saving per transfer avoided from the tele-medicine intervention was €365.Conclusions: Tele-medicine intervention could be worth investing from the Italian National Health Service perspective.
Highlights
Neurosurgical emergencies are costly to the health care systems as well as to the patient, and these are serious in terms of mortality and long-term disability
The literature showed that traumatic brain injury (TBI), vertebral fracture, spinal cord injury (SCI), intracranial hemorrhage (ICH) and peripheral nerve injury are the common form of neuro-surgical emergencies, among them, TBI is a frequent cause
In the Netherland, an estimated 7.1 disability adjusted life-years (DALYs) lost per case was associated with TBI (Scholten et al, 2014)
Summary
Neurosurgical emergencies are costly to the health care systems as well as to the patient, and these are serious in terms of mortality and long-term disability. Tele-medicine intervention can be effective and worth investing for the management of such emergencies. This study aims to evaluate the cost-effectiveness of tele-medicine intervention for the management of neuro-surgical emergencies from the Italian health care perspective. The incidence of cancer of the brain and central nervous system were estimated at 7.8 per 100,000 population with the mortality of 6 cases per 100,000 population in the European countries in 2012 (World Health Organization, 2012). Neuro-surgical emergencies are serious (long-term disability and high mortality) and costly to the national health services. Our study aims to evaluate the cost-effectiveness of tele-video-consultation intervention for the management of neuro-surgical emergencies in the general hospitals
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