A cost-minimization analysis of a realtime teledermatology service in northern Norway

Realtime teledermatology has been a routine service provided by the Univers ity Hospital of Tromso to a primary-care centre in Kirkenes since 1989. The cost of the teledermatology service was compared with the costs of three a lternative methods of treatment for the patients. The first was a combinati on of a visiting service and patient travel to hospital. The second was pat ient travel to the nearest secondary-care centre. The third was a locally e mployed dermatologist. At the actual 1998 workload of 375 patients, the tot al cost of teledermatology was NKr470,780, while the three alternatives cos t NKr880,530, NKr1,635,075 and NKr958,660, respectively. Analysis of the un it costs showed that the realtime teledermatology service, including local phototherapy, was less costly than the three alternatives for annual worklo ads above 195 patients per year. A sensitivity analysis showed that the res ults were robust to changes in the assumptions about the cost structure.