RADIOLOGY SERVICES FOR REMOTE COMMUNITIES - COST MINIMIZATION STUDY OF TELEMEDICINE

Objectives-To determine the social costs of providing a rural populati on with radiology services under three different systems: the existing system (a small x ray unit at the remote site and all other examinati ons at the nearest radiology department (the host site)); a teleradiol ogy system (most examinations at the remote site and more advanced exa minations at the host site); and all examinations at the host site. De sign-Cost minimisation study. Setting-Primary health care in a remote community in Norway. Subjects-A randomly selected sample (n=597) of al l patients (n=1793) having radiological examinations in 1993. Main out come measures-Annual direct medical costs, direct non-medical (travel) costs, and indirect costs (lost production) of the three options. Res ults-After exclusion of costs common to the three systems the direct m edical, direct non-medical, and indirect costs of the three options we re, respectively, pound 9000, pound 51 000, and pound 31 500 (total po und 91 500) for the existing system; pound 108 000, pound 2000, and po und 13 500 (total pound 123 500) for the teleradiology option; and pou nd 0, pound 75 000, and pound 42 000 (pound 117 000 in total) for the ''all at host'' option. Sensitivity analyses indicated that the existi ng system is the least costly option except when lost leisure is value d as highly as lost production. Conclusion-The teleradiology option di d not seem to be cost saving in the study community. Such systems, how ever, may be justified on the grounds of equity of access and quality of care.