Philips Ramez, Seim Nolan, Matrka Laura, Locklear Brittany, Moberly Aaron C, Inman Mark, Essig Garth
Ohio State University College of Medicine Columbus Ohio U.S.A.
Department of Otolaryngology-Head and Neck Surgery Ohio State University Wexner Medical Center Columbus Ohio U.S.A.
Laryngoscope Investig Otolaryngol. 2019 Jan 14;4(2):234-240. doi: 10.1002/lio2.244. eCollection 2019 Apr.
To test the null hypothesis that there is no difference in patient cost savings between the telemedicine and traditional face-to-face approach. The second objective was to assess the financial impact on the peripheral healthcare system, as compared with staffing a conventional clinic with "on-site" otolaryngologist.
Twenty-one patients were enrolled. To assess "patient-benefit" cost savings, a model was formulated that would utilize a certified nurse practitioner (CNP) to conduct a general otolaryngology clinic at the peripheral site, as compared with having to travel to the tertiary referral center. A "peripheral site-benefit" cost analysis was performed to assess costs of initiating and operating a telemedicine clinic at the peripheral site, compared with having an on-site otolaryngologist.
The total patient-benefit cost savings would be $182.09 per patient per encounter and $333.22 per patient annually. The fixed cost to the peripheral site to initiate the telemedicine system was $9,895. Two hundred sixty telemedicine encounters would be needed to offset the initial cost, and 537 encounters would be needed to surpass revenue of the conventional clinic.
A real-time telemedicine otolaryngology clinic provides significant cost savings for both patients and the peripheral healthcare system. This pilot study supports telemedicine as a cost-effective approach to providing general otolaryngology care to rural patients.
检验远程医疗与传统面对面诊疗方式在患者成本节约方面无差异这一零假设。第二个目的是评估与配备“现场”耳鼻喉科医生的传统诊所相比，对周边医疗系统的财务影响。
招募了21名患者。为评估“患者受益”方面的成本节约情况，构建了一个模型，该模型将利用一名执业护士（CNP）在周边地点开展普通耳鼻喉科门诊，与前往三级转诊中心就诊进行对比。进行了“周边地点受益”成本分析，以评估在周边地点启动和运营远程医疗诊所的成本，与配备现场耳鼻喉科医生的情况进行比较。
每次就诊每位患者的总患者受益成本节约为182.09美元，每位患者每年为333.22美元。周边地点启动远程医疗系统的固定成本为9895美元。需要260次远程医疗就诊才能抵消初始成本，需要537次就诊才能超过传统诊所的收入。
实时远程医疗耳鼻喉科诊所可为患者和周边医疗系统显著节约成本。这项初步研究支持远程医疗作为一种为农村患者提供普通耳鼻喉科护理的具有成本效益的方法。
4级。
