Cost-Utility Analysis of Teledermatology Units in Primary Care Centers Versus Face-to-Face Dermatology Consultations in the Hospital.

Autor: Lopez-Villegas A; Laboratory for Research, Education and Planning in Critical and Intensive Care Medicine, CTS-609 Research Group, Poniente University Hospital, El Ejido-Almeria, Spain., Bautista-Mesa RJ; Economic-Financial Directorate, Alto Guadalquivir Hospital, Andujar-Jaen, Spain., Lopez-Liria R; Health Research Centre, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain., Perez-Heredia M; Research Management Department, Primary Care District Poniente of Almería, El Ejido-Almería, Spain., Hernandez-Montoya CJ; Dermatology Unit, Hospital de Poniente, El Ejido-Almeria, Spain., Gutierrez-Maldonado MG; Dermatology Unit, Hospital de Poniente, El Ejido-Almeria, Spain., Leal-Costa C; Nursing Department, University of Murcia, El Palmar-Murcia, Spain., Peiro S; Health Services Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain.
Jazyk: angličtina
Zdroj: Public health nursing (Boston, Mass.) [Public Health Nurs] 2025 Jan-Feb; Vol. 42 (1), pp. 419-434. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1111/phn.13438
Abstrakt: Objective: To perform an economic evaluation to determine whether or not teledermatology (TD) units in primary care (PC) centers offer an alternative in terms of cost-utility and cost per quality-adjusted life years (QALYs) to conventional dermatology consultations (face-to-face dermatology [F-F/D]) at the hospital from the perspective of the Public Health System (PHS) and the patients.
Methods: This is a randomized, controlled, nonblinded, and multicenter study. During 6 months, data from 450 patients (TD: 225 vs. F-F/D: 225) were collected. From both perspectives, costs, quality of life, and costs per QALYs were analyzed. The QALY scores were estimated from the EuroQol-5D-5L (EQ5D-5L) questionnaire responses.
Results: From the perspective of the PHS, the cost per patient was 53.04% lower in the TD group (p < 0.001). Hospital visits decreased by 72.43% in the TD group (p < 0.001). From the patients' perspective, TD reduced costs per patient by 77.59% (p < 0.001). The cost per QALY was 63.34% higher in the F-F/D group (p < 0.001). The TD group's total costs were 56.34% lower (p < 0.001). Furthermore, patients in the TD group gained 0.05 QALYs more than those in the F-F/D group (p = 0.004).
Conclusions: This study shows that TD units in PC represent a significant cost-effective alternative to conventional hospital follow-up. To enhance TD in PC, it is important to introduce remote consultation platforms incorporating artificial intelligence for prediagnosis. This will enable general practitioners and nurses to make more accurate initial assessments. It is also crucial to provide thorough training to healthcare personnel using these technologies to ensure more efficient and personalized care. Public health nurses will benefit from gaining new skills in managing digital tools, which will help in the early identification of dermatological diseases and reduce unnecessary referrals to specialists. This will optimize resources and improve response times for patients.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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