Stalfors Joacim, Björholt Ingela, Westin Thomas
Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
J Telemed Telecare. 2005;11(4):205-10. doi: 10.1258/1357633054068892.
Multidisciplinary team (MDT) meetings are used for establishing diagnosis, for tumour, node, metastasis (TNM) classification and for treatment in head and neck tumour patients in the western region of Sweden. Because of the distances, telemedicine was introduced to link the regional hospital to two of the three district general hospitals (DGHs). We evaluated the costs of presenting patients face to face (FTF) versus via telemedicine. Cost analyses were based on questionnaires completed by patients presented at the MDT meeting. A total of 39 patients were included in the FTF group and 45 patients in the telemedicine group. The cost analysis showed that FTF presentation cost SEK 2267 versus SEK 2036 by telemedicine (difference not significant). The small difference was explained by the fact that the responsible physician accompanied only six of 39 patients when presented FTF, but when presented via telemedicine the DGH physician always participated. A sensitivity analysis revealed that if the responsible physician always accompanied his/her patient for presentation FTF, the cost would be SEK 5366 per patient. This study shows that costs may be saved by carrying out MDT meetings by means of telemedicine instead of FTF.
多学科团队(MDT)会议用于瑞典西部地区头颈肿瘤患者的诊断确立、肿瘤、淋巴结、转移(TNM)分类及治疗。由于距离原因,引入了远程医疗将地区医院与三家区级综合医院(DGH)中的两家相连。我们评估了患者面对面(FTF)就诊与通过远程医疗就诊的成本。成本分析基于在MDT会议上就诊的患者填写的问卷。FTF组共纳入39例患者,远程医疗组纳入45例患者。成本分析表明,FTF就诊的成本为2267瑞典克朗,而远程医疗的成本为2036瑞典克朗(差异不显著)。这种微小差异的原因是,FTF就诊时责任医师仅陪同了39例患者中的6例,而通过远程医疗就诊时DGH医师总是参与。敏感性分析显示,如果责任医师总是陪同其患者进行FTF就诊,每位患者的成本将为5366瑞典克朗。这项研究表明,通过远程医疗而非FTF进行MDT会议可以节省成本。