Cost analysis of a store-and-forward teledermatology consult system in Philadelphia - 08/02/19

Doi : 10.1016/j.jaad.2018.09.036

Xiaoshi Yang, PhD ^a,^b, John S. Barbieri, MD, MBA ^b, Carrie L. Kovarik, MD ^b,^⁎
^a Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning Province, People's Republic of China
^b Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

^∗Reprint requests: Carrie L Kovarik, MD, 3600 Spruce St, Philadelphia, PA 19104.3600 Spruce StPhiladelphiaPA19104

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 08 February 2019
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Abstract

Background

Store-and-forward (SAF) teledermatology (TD) has the potential to increase access to timely, high-quality care for underserved populations. However, the cost-effectiveness of TD for underserved populations is uncertain.

Objective

This study evaluates the potential cost savings associated with an SAF TD program implemented for an underserved population in the city health clinics of urban Philadelphia.

Methods

We performed a retrospective analysis of SAF TD consultations for 700 outpatients managed in 12 Philadelphia primary care clinics. Primary care providers were asked to specify a treatment plan, as well as the type of care for the patient, in the absence of the TD service. Analysis compared the cost of each patient case with use of the TD consult model versus with conventional care.

Results

In all, 27% of in-person dermatology clinic visits (189 of 700) and 3.29% of emergency room visits (23 of 700) were avoided by using TD. Compared with conventional care, TD had a mean expected cost savings of $10.00 to $52.65 per TD consult. In sensitivity analyses, these estimated savings remained positive across a range of parameters.