Tele-orthopedics costs less than hospital visits
In a Norwegian RCT, remote orthopedic video visits cost less than hospital outpatient visits with similar QALY gains.
Source
Cost-Effectiveness of Telemedicine in Remote Orthopedic Consultations: Randomized Controlled Trial
What they did
Alongside a prospective RCT in Troms County, researchers compared costs and QALYs for patients randomized to remote video orthopedic consultations (n=199) versus standard hospital outpatient visits (n=190), taking a societal perspective including travel and production loss.
What they found
Telemedicine cost about €65 less per patient, QALY gains were similar (.09 vs .05, P=.29), and breakeven was 151 consultations per year societally (183 from a health-sector perspective).
The limits
What it doesn't show
Results depend on long travel distances and nurse-hosted remote clinics; cheaper Skype setups or shorter distances change the breakeven, and quality of cheaper video was not evaluated.
Key terms
- QALY
- Quality-adjusted life year combining length and health-related quality of life.
- Societal perspective
- Costing that includes health-system, patient travel, and production-loss costs.
- Breakeven volume
- Annual consultation count at which telemedicine and usual care cost the same.
- Teleorthopedics
- Specialist orthopedic care delivered remotely, here by real-time videoconference.
- EQ-5D
- Generic preference-based questionnaire used to derive utility values for QALYs.
- Incremental costs
- Extra costs that differ between telemedicine and hospital consultations.
Flashcards
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What was the main economic conclusion?
Common questions
Was health outcome worse with video visits?
No significant QALY difference was found between telemedicine and standard consultations.
Who hosted the remote visit?
Trained nurses at the regional center assisted patients; no remote-site physician was present.
What drove savings?
Lower patient travel and production-loss costs outweighed telemedicine equipment and nursing costs above breakeven volume.
How many patients entered analysis?
389 of 402 randomized patients completed consultations after 13 withdrawals/no-shows.
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