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Journal of the American Academy of Dermatology
Volume 66, n° 4
pages 563-570 (avril 2012)
Doi : 10.1016/j.jaad.2011.02.022
accepted : 19 February 2011
Original Articles

Cost-effectiveness analysis of a patient-centered care model for management of psoriasis
 

Kory Parsi, BS, Cindy J. Chambers, MAS, MPH, April W. Armstrong, MD, MPH
Department of Dermatology, University of California, Davis, Sacramento, California 

Correspondence to: April W. Armstrong, MD, MPH, Department of Dermatology, University of California, Davis Health System, 3301 C St, Suite 1400, Sacramento, CA 95816.
Abstract
Introduction

Cost-effectiveness analyses help policymakers make informed decisions regarding funding allocation of health care resources. Cost-effectiveness analysis of technology-enabled models of health care delivery is necessary to assess sustainability of novel online, patient-centered health care models.

Objective

We sought to compare cost-effectiveness of conventional in-office care with a patient-centered, online model for follow-up treatment of patients with psoriasis.

Methods

Cost-effectiveness analysis was performed from a societal perspective on a randomized controlled trial comparing a patient-centered online model with in-office visits for treatment of patients with psoriasis during a 24-week period. Quality-adjusted life expectancy was calculated using the life table method. Costs were generated from the original study parameters and national averages for salaries and services.

Results

No significant difference existed in the mean change in Dermatology Life Quality Index scores between the two groups (online: 3.51 ± 4.48 and in-office: 3.88 ± 6.65, P value = .79). Mean improvement in quality-adjusted life expectancy was not significantly different between the groups (P value = .93), with a gain of 0.447 ± 0.48 quality-adjusted life years for the online group and a gain of 0.463 ± 0.815 quality-adjusted life years for the in-office group. The cost of follow-up psoriasis care with online visits was 1.7 times less than the cost of in-person visits ($315 vs $576).

Limitations

Variations in travel time existed among patients depending on their distance from the dermatologist’s office.

Conclusion

From a societal perspective, the patient-centered online care model appears to be cost saving, while maintaining similar effectiveness to standard in-office care.

The full text of this article is available in PDF format.

Key words : asynchronous teledermatology, cost-benefit analysis, cost-effectiveness analysis, cost-utility analysis, e-health, e-medicine, psoriasis, store-and-forward teledermatology, teledermatology, telemedicine

Abbreviations used : CEA, DLQI, EQ-5D, HRQL, QALE, QALY, RCT



 Funding sources: None.
 Disclosure: Dr Armstrong is an investigator and consultant for Abbot and Centocor. Mr Parsi and Ms Chambers have no conflicts of interest to declare.
 Reprints not available from the authors.



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