title: A cost study of new media supported near oral anticoagulant treatment follow-up.
abstract: OBJECTIVE
  In this study we sought to develop a comparative cost evaluation between conventional and new media, e.g. web, mobile communication technology and digital television, and near patient testing supported anticoagulant (ac) treatment follow-up in a primary health care setting.
  
  
  METHODS
  The comparison was done for two patient groups, self-care and home-care patients, on oral ac treatment in the primary health care centre of the rural and sparsely populated municipality of Ikaalinen. In practise case analysis was used to develop cost functions from collected economic data, which were analysed to determine the break-even point in total cost between conventional and new media supported follow-up for the two patient groups.
  
  
  RESULTS
  In the home-care setting the break-even point is 14 patients; in the self-care setting new media supported follow-up is always more cost-effective.
  
  
  CONCLUSIONS
  The results illustrate that the use of new media and near patient testing in ac treatment follow-up brings about an economic benefit even with a small number of patients in the Ikaalinen setting. However, the sensitivity of break-even to perturbations in the individual costs of the used economic models remains high. Still, when the economic benefits are considered together with the clinical and practical benefits shown to result from self-testing, self-management and use of new media technologies the new service models can be said to provide noticeable benefits both in terms of quality of care and economics in our specific setting.
authors.affiliation: Digital Media Institute, Tampere University of Technology, PO Box 553, 33101, Tampere, Finland. samuli.niiranen@tut.fi
authors.forename: Samuli
authors.initials: S
authors.lastname: Niiranen
authors.forename: Heikki
authors.initials: H
authors.lastname: Lamminen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Niemi
authors.forename: Heikki
authors.initials: H
authors.lastname: Mattila
authors.forename: Seppo
authors.initials: S
authors.lastname: Kalli
mesh_terms: D000284:Administration, Oral; D000465:Algorithms; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D016903:Drug Monitoring / Q000191:economics* / Q000379:methods; D005387:Finland; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D007753:Laboratories; D011320:Primary Health Care / Q000191:economics*; D011369:Professional-Patient Relations; D012648:Self Care; D013685:Telecommunications
chemical_list: D000925:Anticoagulants