K. Harno et al., Clinical effectiveness and cost analysis of patient referral by videoconferencing in orthopaedics, J TELEMED T, 7(4), 2001, pp. 219-225
The clinical effectiveness and costs of videoconferencing in orthopaedics b
etween primary and secondary care were examined in an eight-month prospecti
ve, comparative study. The general surgery outpatient clinics of two Finnis
h district hospitals were compared: Peijas Hospital, with telemedicine, and
Hyvinkaa Hospital, without it. The three study primary-care centres referr
ed a total of 419 adult patients to the outpatient clinics. The population-
based number of referrals to Peijas Hospital was similar to that to Hyvinka
a Hospital after adjusting for the proportion of older people living in the
Hyvinkaa Hospital municipalities. Of the 225 patients referred to Peijas H
ospital, 168 (75%) were given appointments at the outpatient clinic of surg
ery and the rest of the referred patients received a teleconsultation. All
patients referred to Hyvinkaa Hospital were given appointments at the outpa
tient clinic. The direct costs of an outpatient visit were 45% greater per
patient than for a teleconsultation, with a marginal cost decrease of EU48
for every new teleconsultation. A cost-minimization analysis of the alterna
tive interventions showed a net benefit of EU2500 in favour of teleconsulta
tions. The use of videoconferencing between primary and secondary care was
modest in orthopaedics, although the use of this telemedicine method was sh
own to reduce direct costs and be cost-effective.