Martínez Andrés, Villarroel Valentín, Puig-Junoy Jaume, Seoane Joaquín, del Pozo Francisco
Departamento de Teoría de la Señal y Comunicaciones, Universidad Rey Juan Carlos, Madrid, Spain.
J Telemed Telecare. 2007;13(1):7-14. doi: 10.1258/135763307779701176.
Telemedicine systems providing voice communication and email by radio were installed at seven health centres (HCs) and 32 health posts (HPs) in the Alto Amazonas province of Peru during 2001. A cost analysis was performed to estimate the net effect on direct resource consumption from the perspective of society. Prior to the availability of the EHAS telemedicine system, there was a mean of 11.1 urgent patient referrals per year from the HPs and 14.0 referrals per year from the HCs. After the implementation of telemedicine, patient referrals fell to 2.5 per year from the HPs (P = 0.03) and to 8.4 per year from the HCs (P = 0.17). The net economic effect of the telemedicine programme over a four-year period was clearly positive, amounting to annual net savings of US$320,126 (using a 5% discounting rate). A one-way sensitivity analysis using a range of values for the discounting rate, and the number of urgent referrals, confirms that the programme was efficient (i.e. it made net financial savings) in all cases. From the restricted budgetary perspective of the health network, the results also demonstrate that the additional operational costs (telephone and maintenance) introduced by the telemedicine system were lower than the direct cost-savings produced for the health-care network.
2001年，秘鲁上亚马逊省的7个健康中心（HCs）和32个卫生站（HPs）安装了通过无线电提供语音通信和电子邮件的远程医疗系统。从社会角度进行了成本分析，以估计对直接资源消耗的净影响。在EHAS远程医疗系统可用之前，卫生站每年平均有11.1例紧急患者转诊，健康中心每年平均有14.0例转诊。实施远程医疗后，卫生站的患者转诊降至每年2.5例（P = 0.03），健康中心降至每年8.4例（P = 0.17）。远程医疗项目在四年期间的净经济影响显然是积极的，每年净节省320,126美元（使用5%的贴现率）。使用一系列贴现率值和紧急转诊数量进行的单向敏感性分析证实，该项目在所有情况下都是有效的（即实现了净财务节省）。从卫生网络有限的预算角度来看，结果还表明，远程医疗系统引入的额外运营成本（电话和维护）低于为医疗保健网络产生的直接成本节省。
