Speech Pathology Department, Queensland Children's Hospital, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Australia.
J Telemed Telecare. 2023 Sep;29(8):613-620. doi: 10.1177/1357633X211012883. Epub 2021 May 9.
Telepractice models of care have the potential to reduce the time and financial burdens that consumers may experience accessing healthcare services. The current study aimed to conduct a time and financial cost analysis of paediatric feeding appointments accessed via telepractice (using videoconferencing) compared to an in-person model.
Parents of 44 children with paediatric feeding disorders (PFDs) residing in a metropolitan area completed three questionnaires relating to (a) demographics, (b) time and cost for in-person care and (c) time and cost for telepractice. Both cost questionnaires collected data required for direct and indirect costs comparisons (e.g. out-of-pocket costs associated with the appointment (direct), time away from usual duties (indirect)). Average number of services accessed by each participant, and PFD appointments conducted annually by the service, were collected from service statistics. Analysis involved cost minimisation and cost modelling from a societal perspective.
The telepractice appointment resulted in significant time ( = 0.007) and cost (AUD$95.09 per appointment, SD = AUD$64.47, = < 0.0001) savings per family. The health service cost was equivalent for both models (AUD$58.25). Cost modelling identified cost savings of up to AUD$475.45 per family if 50% of appointments in a 10-session block were converted to telepractice. Potential cost savings of AUD$68,750.07 per annum to society could be realised if 50% of feeding appointments within the service were provided via telepractice.
The telepractice model offered both time and cost benefits. Future service re-design incorporating hybrid services (in-person and telepractice) will help optimise benefits and minimise burden for families accessing services for PFDs.
远程医疗模式有可能减轻消费者在获得医疗服务时所经历的时间和经济负担。本研究旨在对通过远程实践（使用视频会议）和面对面模式获得的儿科喂养预约进行时间和经济成本分析。
居住在大都市区的 44 名患有儿科喂养障碍（PFD）的儿童的父母完成了三份问卷，内容涉及（a）人口统计学，（b）面对面护理的时间和成本，以及（c）远程实践的时间和成本。两个成本问卷都收集了直接和间接成本比较所需的数据（例如，与预约相关的自付费用（直接），离开通常职责的时间（间接））。从服务统计数据中收集了每个参与者所接受的服务平均数量以及该服务每年进行的 PFD 预约。分析涉及从社会角度进行成本最小化和成本建模。
远程实践预约使每个家庭在时间（ = 0.007）和成本（AUD$95.09/次，SD = AUD$64.47， = < 0.0001）上都有显著节省。两种模式的医疗服务成本相同（AUD$58.25）。成本建模表明，如果 10 次治疗中 50%的预约转为远程实践，每个家庭可节省高达 AUD$475.45 的费用。如果该服务中 50%的喂养预约通过远程实践提供，则可为社会节省高达 AUD$68,750.07 的年度潜在成本。
远程实践模式具有时间和成本优势。未来的服务重新设计纳入混合服务（面对面和远程实践）将有助于为寻求 PFD 服务的家庭优化利益并减轻负担。
