Cost analysis in telemedicine: empirical evidence from sites in Arizona.
BACKGROUND
Support of telemedicine for largely rural and ethnically diverse populations is premised on expectations that it increases opportunities for appropriate and timely medical services, and that it improves cost-effective service delivery.


OBJECTIVE
To understand the cost-effectiveness of telemedicine in 8 small and/or rural sites in Arizona.


METHODS
A cost analysis framework was used to measure the efficacy of telemedicine in the selected sites from May 1, 2000, to April 30, 2001.


RESULTS
The costs for telemedicine services in half the study sites were more than the costs for conventional face-to-face diagnosis when the volume of telemedicine services used at a site was relatively low. This result persisted even when the opportunity cost for the patients in accessing more traditional types of care was included in the cost estimates.


CONCLUSIONS
These preliminary findings suggest that telemedicine in some instances may not be cost-effective for providing medical specialists for underserved communities, particularly if these networks are underutilized by the patient population. Further analyses are needed to assess factors influencing utilization patterns of telemedicine services by underserved and ethnic communities before implementing these programs at clinical sites.
Chicana/o Studies Program, University of California at Davis, Davis, CA 95616, USA. adelatorre@ucdavis.edu
Adela
A
de la Torre
Clemente
C
Hernández-Rodríguez
Lorena
L
García
D001130:Arizona; D003362:Cost-Benefit Analysis; D004470:Economics, Medical; D005006:Ethnicity / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008511:Medicine / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000191:economics* / Q000706:statistics & numerical data; D013038:Specialization; D017216:Telemedicine / Q000191:economics* / Q000706:statistics & numerical data