An Economic Analysis of Presurgical Teledermatology in Patients with Nonmelanoma Skin Cancer

L. Ferrándiz, D. Moreno-Ramírez, A. Ruiz-de-Casas, A. Nieto-García, P. Moreno-Álvarez, R. Galdeano, F.M. Camacho
2008 Actas Dermo-Sifiliográficas  
Introduction. In patients with nonmelanoma skin cancer, store-and-forward teledermatology allows satisfactory diagnosis and surgical planning, thus shortening waiting lists and reducing travel requirements for patients in special situations. Objective. The aim of this study was to undertake an economic analysis of presurgical teledermatology, comparing it with a conventional health care approach. Material and methods. The cost and cost-effectiveness of presurgical teledermatology were analyzed
more » ... rom a societal perspective in the setting of a public hospital with a corporate intranet. The mean delay in surgery was used to measure effectiveness. Over a 12-month period, teledermatology was used in 134 patients with nonmelanoma skin cancer. The unit cost of each intervention (teledermatology and conventional health care approach), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated. We distinguished between 2 groups of patients: those with and those without physical impediments for travel. Results. The unit cost of the patients in whom teledermatology was used was 1 156.40 compared to 1 278.42 per patient in the conventional system; the conventional system was therefore 1.78 times more expensive than presurgical teledermatology. Teledermatology was more cost-effective, with an incremental cost-effectiveness ratio of 1 3.10 per patient and per day of delay avoided in patients without impediments for travel and 1 4.87 in those with impediments for travel. Conclusion. Teledermatology used for remote presurgical planning and preparation in patients with nonmelanoma skin cancer is more cost-effective than the conventional referral system in a health setting with a communication network available. TELEDERMATOLOGÍA PREQUIRÚRGICA EN PACIENTES CON CÁNCER CUTÁNEO NO MELANOMA. EVALUACIÓN ECONÓMICA Resumen. Introducción. En pacientes con cáncer de piel no melanoma la teledermatología diferida permite una adecuada aproximación diagnóstica y planificación quirúrgica, acortando la demora y evitando desplazamientos en pacientes con situaciones especiales. Objetivo. Evaluación económica de la teledermatología prequirúrgica, comparándola con la asistencia convencional. Material y método. Descripción de costes y análisis coste-efectividad bajo una perspectiva social de la teledermatología prequirúrgica en el ámbito de un hospital público dotado de infraestructura de redes (intranet corporativa). Se consideró como medida de efectividad la demora media hasta la intervención quirúrgica. Durante un período de 12 meses se atendieron un total de 134 pacientes con cáncer no melanoma mediante teledermatología, calculando el coste unitario de cada intervención (teledermatología y asistencia convencional), la ratio de coste entre la alternativa más cara
doi:10.1016/s1578-2190(08)70368-8 fatcat:aheaojdowjb3lkunye4fgf7lsm