Sayani Saleem, Muzammil Momina, Saleh Karima, Muqeet Abdul, Zaidi Fabiha, Shaikh Tehniat
Aga Khan University, Karachi, Pakistan.
Aga Khan Development Network Digital Health Resource Centre, Aga Khan University, National Stadium Road, Karachi City, Sindh 74800, Pakistan.
Ther Adv Chronic Dis. 2019 Dec 4;10:2040622319891587. doi: 10.1177/2040622319891587. eCollection 2019.
Despite evidence supporting telehealth provision in developed countries, there is limited evidence regarding its economic benefits for patients living in areas where access and cost present major barriers to health care, particularly in low- and middle-income countries (LMICs). This study explores the economic benefits of telemedicine for patients, in terms of cost and times savings, and its potential role in improving chronic disease outcomes.
This retrospective cross-sectional study compared telemedicine services with hypothetical in-person consultations, with a focus on patient travel time and travel cost savings. A database containing teleconsultation visits ( = 25,182) conducted at health facilities in remote regions of Afghanistan, Pakistan, Tajikistan, and the Kyrgyz Republic, was analyzed. A two-sample homoscedastic test was used to determine differences between the two groups. A one-way sensitivity analysis was also conducted, presuming in-person teleconsultations at 90%, 75%, and 50%.
The study extracted data from 25,182 teleconsultation visits (12,814 males; 12,368 females). The cumulative patient savings through the program amounted to USD 9,175,132, and 1,876,146 h, or 213.1 years. A significant difference was seen between the two groups in terms of mean time savings (-value <0.05), and a nearly significant difference was observed in terms of mean cost savings (-value = 0.05).
This study suggests that considerable economic benefits imparted to patients in low-resource settings of LMICs via accessing telemedicine. Telemedicine has great potential to improve chronic disease outcomes in low-resource areas by reducing socioeconomic barriers related to cost and access, and increasing uptake of services, thereby enabling early intervention and long-term management.
尽管有证据支持在发达国家提供远程医疗服务，但对于生活在医疗服务获取和成本存在重大障碍地区的患者，尤其是在低收入和中等收入国家（LMICs），其经济效益的证据有限。本研究探讨了远程医疗对患者的经济效益，包括成本和时间节省，以及其在改善慢性病治疗结果方面的潜在作用。
这项回顾性横断面研究将远程医疗服务与假设的面对面咨询进行了比较，重点关注患者的出行时间和出行成本节省。分析了一个包含在阿富汗、巴基斯坦、塔吉克斯坦和吉尔吉斯共和国偏远地区医疗机构进行的远程会诊（n = 25,182）的数据库。使用双样本同方差t检验来确定两组之间的差异。还进行了单向敏感性分析，假设面对面远程会诊的比例为90%、75%和50%。
该研究从25,182次远程会诊中提取了数据（男性12,814例；女性12,368例）。通过该项目累计为患者节省了9,175,132美元和1,876,146小时，即213.1年。两组在平均时间节省方面存在显著差异（p值<0.05），在平均成本节省方面观察到接近显著的差异（p值 = 0.05）。
本研究表明，通过获取远程医疗服务，低收入和中等收入国家资源匮乏地区的患者可获得可观的经济效益。远程医疗有很大潜力通过减少与成本和获取相关的社会经济障碍，增加服务利用，从而实现早期干预和长期管理，改善资源匮乏地区的慢性病治疗结果。
