Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
J Ultrasound Med. 2023 Jan;42(1):109-123. doi: 10.1002/jum.16070. Epub 2022 Jul 30.
Telerobotic ultrasound technology allows radiologists and sonographers to remotely provide ultrasound services in underserved areas. This study aimed to compare costs associated with using telerobotic ultrasound to provide ultrasound services in rural and remote communities to costs associated with alternate models.
A cost-minimization approach was used to compare four ultrasound service delivery models: telerobotic ultrasound (Model 1), telerobotic ultrasound and an itinerant sonographer (Model 2), itinerant sonographer without telerobotic ultrasound (Model 3), and travel to another community for all exams (Model 4). In Models 1-3, travel was assumed when exams could not be successfully performed telerobotically or by an itinerant sonographer. A publicly funded healthcare payer perspective was used for the reference case and a societal perspective was used for a secondary non-reference case. Costs were based on the literature and experience using telerobotic ultrasound in Saskatchewan, Canada. Costs were expressed in 2020 Canadian dollars.
Average cost per ultrasound exam was $342, $323, $368, and $478 for Models 1, 2, 3, and 4, respectively, from a publicly funded healthcare payer perspective, and $461, $355, $447, and $849, respectively, from a societal perspective. In one-way sensitivity analyses, Model 2 was the lowest cost from a payer perspective for communities with population >2075 people, distance >350 km from the nearest ultrasound facility, or >47% of the population eligible for publicly funded medical transportation.
Health systems may wish to consider solutions such as telerobotic ultrasound and itinerant sonographers to reduce healthcare costs and improve access to ultrasound in rural and remote communities.
远程机器人超声技术使放射科医生和超声医师能够在服务不足的地区远程提供超声服务。本研究旨在比较在农村和偏远社区使用远程机器人超声提供超声服务的相关成本与替代模式的成本。
采用成本最小化方法比较了四种超声服务提供模式:远程机器人超声(模式 1)、远程机器人超声和巡回超声技师(模式 2)、无远程机器人超声的巡回超声技师(模式 3)以及所有检查均前往另一个社区(模式 4)。在模式 1-3 中,当远程机器人或巡回超声技师无法成功进行检查时,假设会进行旅行。参考案例采用公共资助医疗保健支付方视角,非参考案例采用社会视角。成本基于在加拿大萨斯喀彻温省使用远程机器人超声的文献和经验。成本以 2020 年加元表示。
从公共资助医疗保健支付方的角度来看,模型 1、2、3 和 4 的平均每次超声检查成本分别为 342 加元、323 加元、368 加元和 478 加元,从社会视角来看,相应的成本分别为 461 加元、355 加元、447 加元和 849 加元。在单向敏感性分析中,对于人口>2075 人、距离最近的超声设施>350km 或>47%的人口有资格获得公共资助医疗交通的社区,从支付方的角度来看,模式 2 的成本最低。
卫生系统可能希望考虑采用远程机器人超声和巡回超声技师等解决方案,以降低医疗成本并改善农村和偏远社区的超声服务获取。