title: Cost-effectiveness analysis of a patient-centered care model for management of psoriasis.
abstract: BACKGROUND
  Cost-effectiveness analyses help policymakers make informed decisions regarding funding allocation of health care resources. Cost-effectiveness analysis of technology-enabled models of health care delivery is necessary to assess sustainability of novel online, patient-centered health care models.
  
  
  OBJECTIVE
  We sought to compare cost-effectiveness of conventional in-office care with a patient-centered, online model for follow-up treatment of patients with psoriasis.
  
  
  METHODS
  Cost-effectiveness analysis was performed from a societal perspective on a randomized controlled trial comparing a patient-centered online model with in-office visits for treatment of patients with psoriasis during a 24-week period. Quality-adjusted life expectancy was calculated using the life table method. Costs were generated from the original study parameters and national averages for salaries and services.
  
  
  RESULTS
  No significant difference existed in the mean change in Dermatology Life Quality Index scores between the two groups (online: 3.51 ± 4.48 and in-office: 3.88 ± 6.65, P value = .79). Mean improvement in quality-adjusted life expectancy was not significantly different between the groups (P value = .93), with a gain of 0.447 ± 0.48 quality-adjusted life years for the online group and a gain of 0.463 ± 0.815 quality-adjusted life years for the in-office group. The cost of follow-up psoriasis care with online visits was 1.7 times less than the cost of in-person visits ($315 vs $576).
  
  
  CONCLUSIONS
  Variations in travel time existed among patients depending on their distance from the dermatologist's office.
  
  
  CONCLUSIONS
  From a societal perspective, the patient-centered online care model appears to be cost saving, while maintaining similar effectiveness to standard in-office care.
authors.affiliation: Department of Dermatology, University of California, Davis, Sacramento, California 95816, USA.
authors.forename: Kory
authors.initials: K
authors.lastname: Parsi
authors.forename: Cindy J
authors.initials: CJ
authors.lastname: Chambers
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D018802:Patient-Centered Care / Q000191:economics*; D011565:Psoriasis / Q000191:economics* / Q000628:therapy*