Costs and Benefits of Telemedicine Compared to Face-to-Face Treatment in Patients with Lower Extremity Ulcers

Objective: Telemedicine (TM) is an evolving method in lower extremity ulcer (LEU) treatment. Previous studies have demonstrated TM as comparable to the same-room care in clinical outcomes measures. Conversely, economic assessments of TM initiative were scarce and inconsistent. This study aims to analyze the costs and benefits of TM in LEU treatment and to propose a TM implementation decision-scoring model. Approach: This cost minimization analysis was performed at Maccabi Healthcare Services (Israel) during January 1, 2013-June 31, 2017 period. The study was based on cost difference assessment. A decision-scoring model for TM implementation was constructed. Results: The cost per patient in TM modality, compared to the same-room care, was 7% higher; however, in a proportion similar to same-room care, the cost of TM was lower. The TM implementation decision score was 0.236, while the weight of the direct cost factors is 0.70. Face-to-face only model, compared to the study sample, demonstrated 30% higher costs. Innovation: The study brings new evidence to an LEU treatment domain with little previous research. Also, a TM decision implementation scoring model has been provided. Conclusions: The decision support model may be instrumental in the TM implementation process.