Journal of Telemedicine and Telecare > Volume 15, Number 1 > Pp. 40-45

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RESEARCH Original articles

Economic evaluation of a store-and-forward teledermatology system for skin cancer patients

David Moreno-Ramirez ^* , Lara Ferrandiz ^*, Andres Ruiz-de-Casas ^*, Adoracion Nieto-Garcia , Pedro Moreno-Alvarez , Rafael Galdeano  and Francisco M Camacho ^*

^* Dermatology Department, Hospital Universitario Virgen Macarena, Seville; Department of Social and Health Sciences, Faculty of Medicine, University of Seville, Seville; Primary Care Centre, San José, Seville; Primary Care Area ‘Sevilla’, Seville, Spain

Correspondence: Dr David Moreno-Ramirez, Dermatology Department, Hospital Universitario Virgen Macarena, Avda. Dr. Fedriani s/n 41009, Seville, Spain (Fax: +34 9 5438 2763; Email: dmoreno{at}e-derma.org)

We conducted an economic analysis of a store-and-forward teledermatology system for the routine triage of skin cancer patients. A cost-identification, cost-effectiveness and sensitivity analysis under a societal perspective was used to compare teledermatology with the conventional care alternative. In the period March 2004 to July 2005, a total of 2009 teledermatology referrals were managed from 12 Primary Care Centres (PCCs) of the public health system. The unit cost was of 79.78 per patient in teledermatology, and 129.37 per patient in conventional care (P < 0.005), with an incremental cost of 49.59 per patient in favour of teledermatology. The cost ratio between teledermatology and conventional care was 1.6. There was a significant inverse relation between the unit cost in each participating PCC and the number of teleconsultations transmitted from them (P < 0.001). Teledermatology resulted in a more cost-effective, or dominant, methodology. In a public health system equipped with an intranet, the routine use of teledermatology in skin cancer clinics is a cost-effective method of managing referrals.

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