The costs and potential savings of a novel telepaediatric service in Queensland.
BACKGROUND
There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person.


METHODS
In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialties including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry.


RESULTS
During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was 1,553,264 Australian dollars; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider.


CONCLUSIONS
Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.
Smith
Anthony C
AC
Centre for Online Health, University of Queensland, Level 3 Foundation Building, Royal Children's Hospital, Herston, Brisbane, Queensland, 4029, Australia. a.smith@pobox.com
Scuffham
Paul
P
Wootton
Richard
R
D002648:Child; D017046:Cost Savings; D017281:Cost of Illness; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics; D006776:Hospitals, Pediatric / Q000191:economics; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D010372:Pediatrics / Q000191:economics* / Q000379:methods; D011793:Queensland; D012017:Referral and Consultation / Q000191:economics; D019114:Remote Consultation / Q000191:economics* / Q000295:instrumentation / Q000706:statistics & numerical data; D014186:Transportation / Q000191:economics; D049269:Videoconferencing / Q000191:economics* / Q000295:instrumentation / Q000706:statistics & numerical data