Center for Telemedicine and Telehealth, University of Kansas Medical Center, Kansas City, Kansas, USA.
Telemed J E Health. 2010 Oct;16(8):867-71. doi: 10.1089/tmj.2010.0054. Epub 2010 Oct 6.
The costs of pediatric telemedicine services remain underreported and understudied; however, there is evidence that telepediatric services can be cost competitive with traditional ones. For 15 years, the University of Kansas Center for Telemedicine and Telehealth has been providing telemental health outreach from the University of Kansas Medical Center (KUMC). One service site is located in Crawford County, Kansas, which provides telepsychiatry services to children and adolescents. The purpose of this study was to examine the costs of operating the Crawford County site relative to accessing services at KUMC, the likely alternative service location. The cost of travel time to parents who accompanied a dependent to either location also was estimated. Patients and parents were examined over a 6-month period in 2006. One hundred thirty-two patients received 257 telemedicine psychiatric consultations during this period. Cost estimates for using the pediatric telemedicine service were assessed for all patients; however, travel and related costs were collected from a sample of 26 patient-parent dyads. The estimated costs of services were obtained using standard cost-accounting procedures. An average cost per consultation in Crawford County was $168.61. The cost savings in travel time and other expenses to parents and patients were substantial between use of the county site and KUMC. Subtracting average savings in travel costs to patients and parents produced an average cost of a telepsychiatry consult in Crawford County of only $30.99. This study was conducted over 6 months with a small number of observations; it should be replicated over a longer study period, with more patients, and with more data that might capture marginal costs of services.
儿科远程医疗服务的成本仍未得到充分报告和研究；然而，有证据表明，远程儿科服务可以与传统服务具有成本竞争力。堪萨斯大学远程医疗中心（University of Kansas Center for Telemedicine and Telehealth）在过去的 15 年中一直从堪萨斯大学医疗中心（KUMC）提供远程精神健康服务。一个服务地点位于堪萨斯州克劳福德县，为儿童和青少年提供远程精神病服务。本研究的目的是考察运营克劳福德县服务站点的成本相对于堪萨斯大学医疗中心（KUMC）的服务成本，后者是可能的替代服务地点。还估计了陪同依赖儿童前往任何一个地点的父母的旅行时间成本。2006 年期间，对患者和父母进行了为期 6 个月的检查。在此期间，有 132 名患者接受了 257 次远程医疗精神病学咨询。对所有患者评估了使用儿科远程医疗服务的成本估计；然而，仅从 26 对患者-家长对中收集了旅行和相关成本的样本。使用标准成本核算程序估算了服务的估计成本。克劳福德县的每次咨询平均成本为 168.61 美元。在使用县服务站点和 KUMC 之间，父母和患者的旅行时间和其他费用节省非常可观。从患者和家长的旅行费用平均节省中减去，克劳福德县的远程精神病学咨询的平均费用仅为 30.99 美元。本研究在 6 个月内进行，观察数量较少；应在更长的研究期间、更多的患者和可能捕获服务边际成本的更多数据上进行复制。
