Moirangthem Sydney, Rao Sabina, Kumar Channaveerachari Naveen, Narayana Manjunatha, Raviprakash Neelaveni, Math Suresh Bada
Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India.
Indian J Psychol Med. 2017 May-Jun;39(3):271-275. doi: 10.4103/IJPSYM.IJPSYM_441_16.
In a resource-poor country such as India, telepsychiatry could be an economical method to expand health-care services. This study was planned to compare the costing and feasibility of three different service delivery models. The end user was a state-funded long-stay Rehabilitation Center (RC) for the homeless.
Model A comprised patients going to a tertiary care center for clinical care, Model B was community outreach service, and Model C comprised telepsychiatry services. The costing included expenses incurred by the health system to complete a single consultation for a patient on an outpatient basis. It specifically excluded the cost borne by the care-receiver. No patients were interviewed for the study.
The RC had 736 inmates, of which 341 had mental illness of very long duration. On comparing the costing, Model A costed 6047.5 INR (100$), Model B costed 577.1 INR (9.1$), and Model C costed 137.2 INR (2.2$). Model C was found fifty times more economical when compared to Model A and four times more economical when compared to Model B.
Telepsychiatry services connecting tertiary center and a primary health-care center have potential to be an economical model of service delivery compared to other traditional ones. This resource needs to be tapped in a better fashion to reach the unreached.
在印度这样资源匮乏的国家，远程精神病学可能是一种扩大医疗服务的经济方法。本研究旨在比较三种不同服务提供模式的成本和可行性。最终用户是一家由国家资助的为无家可归者提供长期服务的康复中心（RC）。
模式A包括患者前往三级医疗中心接受临床护理，模式B是社区外展服务，模式C包括远程精神病学服务。成本核算包括卫生系统为患者在门诊完成一次会诊所产生的费用。特别排除了接受护理者承担的费用。本研究未对患者进行访谈。
康复中心有736名住院患者，其中341名患有长期精神疾病。在比较成本时，模式A花费6047.5印度卢比（100美元），模式B花费577.1印度卢比（9.1美元），模式C花费137.2印度卢比（2.2美元）。与模式A相比，模式C的成本效益高出五十倍，与模式B相比高出四倍。
与其他传统模式相比，连接三级中心和初级医疗保健中心的远程精神病学服务有潜力成为一种经济的服务提供模式。需要更好地利用这一资源，以惠及未得到服务的人群。
