Antonio Lopez-Villegas, Rafael Jesus Bautista-Mesa, Remedios Lopez-Liria, Mercedes Perez-Heredia, Carlos Javier Hernandez-Montoya, Maria Gador Gutierrez-Maldonado, Cesar Leal-Costa, Salvador Peiro
{"title":"基层医疗中心远程皮肤科与医院面对面皮肤科咨询的成本效用分析。","authors":"Antonio Lopez-Villegas, Rafael Jesus Bautista-Mesa, Remedios Lopez-Liria, Mercedes Perez-Heredia, Carlos Javier Hernandez-Montoya, Maria Gador Gutierrez-Maldonado, Cesar Leal-Costa, Salvador Peiro","doi":"10.1111/phn.13438","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To perform an economic evaluation to determine whether or not teledermatology (TD) units in primary care (PC) centers offer an alternative in terms of cost-utility and cost per quality-adjusted life years (QALYs) to conventional dermatology consultations (face-to-face dermatology [F-F/D]) at the hospital from the perspective of the Public Health System (PHS) and the patients.</p><p><strong>Methods: </strong>This is a randomized, controlled, nonblinded, and multicenter study. During 6 months, data from 450 patients (TD: 225 vs. F-F/D: 225) were collected. From both perspectives, costs, quality of life, and costs per QALYs were analyzed. The QALY scores were estimated from the EuroQol-5D-5L (EQ5D-5L) questionnaire responses.</p><p><strong>Results: </strong>From the perspective of the PHS, the cost per patient was 53.04% lower in the TD group (p < 0.001). Hospital visits decreased by 72.43% in the TD group (p < 0.001). From the patients' perspective, TD reduced costs per patient by 77.59% (p < 0.001). The cost per QALY was 63.34% higher in the F-F/D group (p < 0.001). The TD group's total costs were 56.34% lower (p < 0.001). Furthermore, patients in the TD group gained 0.05 QALYs more than those in the F-F/D group (p = 0.004).</p><p><strong>Conclusions: </strong>This study shows that TD units in PC represent a significant cost-effective alternative to conventional hospital follow-up. To enhance TD in PC, it is important to introduce remote consultation platforms incorporating artificial intelligence for prediagnosis. This will enable general practitioners and nurses to make more accurate initial assessments. It is also crucial to provide thorough training to healthcare personnel using these technologies to ensure more efficient and personalized care. Public health nurses will benefit from gaining new skills in managing digital tools, which will help in the early identification of dermatological diseases and reduce unnecessary referrals to specialists. This will optimize resources and improve response times for patients.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":"419-434"},"PeriodicalIF":1.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cost-Utility Analysis of Teledermatology Units in Primary Care Centers Versus Face-to-Face Dermatology Consultations in the Hospital.\",\"authors\":\"Antonio Lopez-Villegas, Rafael Jesus Bautista-Mesa, Remedios Lopez-Liria, Mercedes Perez-Heredia, Carlos Javier Hernandez-Montoya, Maria Gador Gutierrez-Maldonado, Cesar Leal-Costa, Salvador Peiro\",\"doi\":\"10.1111/phn.13438\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To perform an economic evaluation to determine whether or not teledermatology (TD) units in primary care (PC) centers offer an alternative in terms of cost-utility and cost per quality-adjusted life years (QALYs) to conventional dermatology consultations (face-to-face dermatology [F-F/D]) at the hospital from the perspective of the Public Health System (PHS) and the patients.</p><p><strong>Methods: </strong>This is a randomized, controlled, nonblinded, and multicenter study. During 6 months, data from 450 patients (TD: 225 vs. F-F/D: 225) were collected. From both perspectives, costs, quality of life, and costs per QALYs were analyzed. The QALY scores were estimated from the EuroQol-5D-5L (EQ5D-5L) questionnaire responses.</p><p><strong>Results: </strong>From the perspective of the PHS, the cost per patient was 53.04% lower in the TD group (p < 0.001). Hospital visits decreased by 72.43% in the TD group (p < 0.001). From the patients' perspective, TD reduced costs per patient by 77.59% (p < 0.001). The cost per QALY was 63.34% higher in the F-F/D group (p < 0.001). The TD group's total costs were 56.34% lower (p < 0.001). Furthermore, patients in the TD group gained 0.05 QALYs more than those in the F-F/D group (p = 0.004).</p><p><strong>Conclusions: </strong>This study shows that TD units in PC represent a significant cost-effective alternative to conventional hospital follow-up. To enhance TD in PC, it is important to introduce remote consultation platforms incorporating artificial intelligence for prediagnosis. This will enable general practitioners and nurses to make more accurate initial assessments. It is also crucial to provide thorough training to healthcare personnel using these technologies to ensure more efficient and personalized care. Public health nurses will benefit from gaining new skills in managing digital tools, which will help in the early identification of dermatological diseases and reduce unnecessary referrals to specialists. This will optimize resources and improve response times for patients.</p>\",\"PeriodicalId\":54533,\"journal\":{\"name\":\"Public Health Nursing\",\"volume\":\" \",\"pages\":\"419-434\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/phn.13438\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/phn.13438","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/15 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
Cost-Utility Analysis of Teledermatology Units in Primary Care Centers Versus Face-to-Face Dermatology Consultations in the Hospital.
Objective: To perform an economic evaluation to determine whether or not teledermatology (TD) units in primary care (PC) centers offer an alternative in terms of cost-utility and cost per quality-adjusted life years (QALYs) to conventional dermatology consultations (face-to-face dermatology [F-F/D]) at the hospital from the perspective of the Public Health System (PHS) and the patients.
Methods: This is a randomized, controlled, nonblinded, and multicenter study. During 6 months, data from 450 patients (TD: 225 vs. F-F/D: 225) were collected. From both perspectives, costs, quality of life, and costs per QALYs were analyzed. The QALY scores were estimated from the EuroQol-5D-5L (EQ5D-5L) questionnaire responses.
Results: From the perspective of the PHS, the cost per patient was 53.04% lower in the TD group (p < 0.001). Hospital visits decreased by 72.43% in the TD group (p < 0.001). From the patients' perspective, TD reduced costs per patient by 77.59% (p < 0.001). The cost per QALY was 63.34% higher in the F-F/D group (p < 0.001). The TD group's total costs were 56.34% lower (p < 0.001). Furthermore, patients in the TD group gained 0.05 QALYs more than those in the F-F/D group (p = 0.004).
Conclusions: This study shows that TD units in PC represent a significant cost-effective alternative to conventional hospital follow-up. To enhance TD in PC, it is important to introduce remote consultation platforms incorporating artificial intelligence for prediagnosis. This will enable general practitioners and nurses to make more accurate initial assessments. It is also crucial to provide thorough training to healthcare personnel using these technologies to ensure more efficient and personalized care. Public health nurses will benefit from gaining new skills in managing digital tools, which will help in the early identification of dermatological diseases and reduce unnecessary referrals to specialists. This will optimize resources and improve response times for patients.
期刊介绍：
Public Health Nursing publishes empirical research reports, program evaluations, and case reports focused on populations at risk across the lifespan. The journal also prints articles related to developments in practice, education of public health nurses, theory development, methodological innovations, legal, ethical, and public policy issues in public health, and the history of public health nursing throughout the world. While the primary readership of the Journal is North American, the journal is expanding its mission to address global public health concerns of interest to nurses.
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