Malone F D, Athanassiou A, Craigo S D, Simpson L L, D'Alton M E
Division of Maternal-Fetal Medicine, Tufts University School of Medicine, New England Medical Center, Boston 02111, USA.
Ultrasound Obstet Gynecol. 1998 Aug;12(2):120-4. doi: 10.1046/j.1469-0705.1998.12020120.x.
The purpose of this study was to describe the cost implications of converting an established videotape review network for obstetric ultrasonography to one based on telemedicine technology.
Retrospective review of fixed and non-fixed costs associated with interpreting obstetric ultrasound examinations using both videotape and telemedicine transmission.
A network of three community offices transmitting 600 obstetric ultrasound examinations per month to a central tertiary level facility.
Sonographers at the community offices record ultrasound examinations onto videotape, which are then sent by courier to a central facility for interpretation. At the completion of this videotaped examination, sonographers repeat the ultrasound scan while transmitting real-time images over a telemedicine link to the central facility. Costs associated with the videotape review technique that can be avoided by converting to telemedicine interpretation were derived and compared with the fixed and non-fixed costs associated with establishing the telemedicine network.
For this network, the fixed costs for establishing telemedicine are $101,750. Monthly non-fixed cost savings by eliminating videotape review include $1620 to $2700 for printing still images, $1200 for courier charges and $7000 for fewer repeat ultrasound examinations. Monthly non-fixed costs for the telemedicine network are $2415. Net monthly savings in non-fixed costs for a telemedicine network are therefore $7405 to $8585, which may pay for the initial fixed costs in 12 to 14 months.
The high cost of a telemedicine network may be offset by possible savings in non-fixed costs compared with alternative systems for interpreting obstetric ultrasonography.
本研究旨在描述将现有的产科超声录像审查网络转换为基于远程医疗技术的网络所产生的成本影响。
回顾性分析使用录像和远程医疗传输解读产科超声检查相关的固定成本和非固定成本。
一个由三个社区办公室组成的网络，每月向一家中心三级医疗机构传输600例产科超声检查。
社区办公室的超声检查技师将超声检查记录在录像带上，然后通过快递发送到中心机构进行解读。在完成录像检查后，超声检查技师在通过远程医疗链接向中心机构传输实时图像的同时重复超声扫描。得出通过转换为远程医疗解读可避免的与录像审查技术相关的成本，并与建立远程医疗网络相关的固定成本和非固定成本进行比较。
对于该网络，建立远程医疗的固定成本为101,750美元。通过消除录像审查每月节省的非固定成本包括：打印静态图像节省1620至2700美元、快递费用节省1200美元以及减少重复超声检查节省7000美元。远程医疗网络的每月非固定成本为2415美元。因此，远程医疗网络每月非固定成本的净节省为7405至8585美元，这可能在12至14个月内支付初始固定成本。
与解读产科超声的其他系统相比，远程医疗网络的高成本可能会被非固定成本的可能节省所抵消。
