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Inicio Cirugía Española (English Edition) Economic impact of outpatient follow-up using telemedicine vs in-person visits f...
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Vol. 102. Issue 6.
Pages 314-321 (June 2024)
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Vol. 102. Issue 6.
Pages 314-321 (June 2024)
Original article
Economic impact of outpatient follow-up using telemedicine vs in-person visits for patients in general surgery: A secondary analysis of a randomized clinical trial
Impacto económico del seguimiento ambulatorio mediante telemedicina vs. visita presencial a pacientes de cirugía general: un análisis secundario de un ensayo clínico aleatorizado
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Georgina Ferreta,1, Manel Cremadesb,1, Lídia Cornejoa, Francesc Guillem-Lópezb, Ramon Farrésa, David Parésb,
Corresponding author
davidpares.germanstrias@gencat.cat

Corresponding author at: Department of General Surgery, Section of Colorectal Surgery, Hospital Universitari Germans Trias i Pujol, School of Medicine, Universitat Autònoma de Barcelona, Institut de Rcerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain.
, Joan-Francesc Julianb
a Department of General Surgery, Hospital Universitari Doctor Josep Trueta, Avda. França s/n, 17007 Girona, Spain
b Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain
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Figures (2)
Tables (5)
Table 1. Diagnostics in each group of study.
Table 2. Staff cost and loss of productivity costs in each assigned group.
Table 3. Initial investment in Telemedicine group.
Table 4. Patient’s characteristics in each group of study.
Table 5. Healthcare System Costs and patients costs per visit (units in €) per month according to study group.
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Abstract
Introduction

Innovation in internet connectivity and the Covid 19 pandemic have caused a dramatic change in the management of patients in the medical field, boosting the use of telemedicine. A comparison of clinical outcomes and satisfaction between conventional face-to-face and telemedicine follow-up in general surgery, an economic evaluation is mandatory.

The aim of the present study was to compare the differences in economic costs between these two outpatient approaches in a designed randomized controlled trial (RCT).

Methods

A RCT was conducted enrolling 200 patients to compare conventional in-person vs. digital health follow-up using telemedicine in the outpatient clinics in patients of General Surgery Department after their planned discharge. After a demonstration that no differences were found in clinical outcomes and patient satisfaction, we analyzed the medical costs, including staff wages, initial investment, patent’s transportation and impact on social costs.

Results

After an initial investment of 7527.53€, the costs for the Medical institution of in-person conventional follow-up were higher (8180.4€) than those using telemedicine (4630.06€). In relation to social costs, loss of productivity was also increased in the conventional follow-up.

Conclusion

The use of digital Health telemedicine is a cost-effective approach compared to conventional face-to-face follow-up in patients of General Surgery after hospital discharge.

Keywords:
Telemedicine
General surgery
Cost-effective study
Follow-up, Randomized controlled trial
Resumen
Introduccion

La innovación en la conectividad a internet y la pandemia de Covid 19 han provocado un cambio dramático en la gestión de pacientes en el ámbito médico, impulsando el uso de la telemedicina. Una comparación de resultados clínicos y satisfacción entre el seguimiento convencional presencial y por telemedicina en cirugía general, es obligatoria una evaluación económica. El objetivo del presente estudio fue comparar las diferencias en los costos económicos entre estos dos enfoques ambulatorios en un ensayo controlado aleatorio (ECA) diseñado.

Métodos

Se realizó un ECA que inscribió a 200 pacientes para comparar el seguimiento de salud convencional en persona versus el seguimiento de salud digital mediante telemedicina en las clínicas ambulatorias en pacientes del Departamento de Cirugía General después de su alta planificada. Después de demostrar que no se encontraron diferencias en los resultados clínicos y la satisfacción del paciente, analizamos los costos médicos, incluidos los salarios del personal, la inversión inicial, el transporte de patentes y el impacto en los costos sociales.

Resultados

Después de una inversión inicial de 7.527,53 €, los costes para la Institución Médica de seguimiento convencional presencial fueron superiores (8.180,4 €) que los de telemedicina (4.630,06 €). En relación a los costos sociales, la pérdida de productividad también se incrementó en el seguimiento convencional.

Conclusión

El uso de la telemedicina digital en Salud es un enfoque costo-efectivo en comparación con el seguimiento presencial convencional en pacientes de Cirugía General después del alta hospitalaria.

Palabras clave:
Telemedicina
Cirugía General
Estudio económico
Seguimiento, Ensayo clínico aleatorizado

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