Economic Assessment and Budgetary Impact of a Telemedicine Procedure and Spirometry Quality Control in the Primary Care Setting.
OBJECTIVE
To evaluate the economic impact of a telemedicine procedure designed to improve the quality of lung function testing (LFT) in primary care in a public healthcare system, compared with the standard method.


METHODS
The economic impact of 9,039 LFTs performed in 51 health centers (2010-2013) using telespirometry (TS) compared to standard spirometry (SS) was studied.


RESULTS
TS costs more per unit than SS (€47.80 vs. €39.70) (2013), but the quality of the TS procedure is superior (84% good quality, compared to 61% using the standard procedure). Total cost of TS was €431,974 (compared with €358,306€ for SS), generating an economic impact of €73,668 (2013). The increase in cost for good quality LFT performed using TS was €34,030 (2010) and €144,295 (2013), while the costs of poor quality tests fell by €15,525 (2010) and 70,627€ (2013).


CONCLUSIONS
The cost-effectiveness analysis concludes that TS is 23% more expensive and 46% more effective. Healthcare costs consequently fall as the number of LFTs performed by TS rises. Avoiding poor quality, invalid LFTs generates savings that compensate for the increased costs of performing LFTs with TS, making it a cost-effective method.
Departamento de Neumología, Hospital Universitario Cruces, Barakaldo, España. Electronic address: nuria.marinamalanda@osakidetza.net.
Nuria
N
Marina
Servicio de Evaluación de Tecnologías Sanitarias (OSTEBA), Departamento de Salud del Gobierno Vasco, Vitoria-Gasteiz, España.
Juan Carlos
JC
Bayón
Departamento de Neumología, Hospital Universitario Cruces, Barakaldo, España.
Elena
E
López de Santa María
Servicio de Evaluación de Tecnologías Sanitarias (OSTEBA), Departamento de Salud del Gobierno Vasco, Vitoria-Gasteiz, España.
Asunción
A
Gutiérrez
Departamento de Neumología, Hospital Universitario Cruces, Barakaldo, España.
Marta
M
Inchausti
Departamento de Neumología, Hospital Universitario Basurto, Bilbao, España; Universidad del País Vasco (UPV-EHU) Biocruces, Hospital Universitario Cruces, Barakaldo, España.
Victor
V
Bustamante
Departamento de Neumología, Hospital Universitario Cruces, Barakaldo, España; Departamento de Neumología, Hospital Universitario Basurto, Bilbao, España; Universidad del País Vasco (UPV-EHU) Biocruces, Hospital Universitario Cruces, Barakaldo, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), España.
Juan B
JB
Gáldiz
D002017:Budgets; D003362:Cost-Benefit Analysis; D006801:Humans; D011320:Primary Health Care; D011786:Quality Control; D013147:Spirometry / Q000191:economics* / Q000592:standards*; D017216:Telemedicine / Q000191:economics*
Calidad de la espirometría; Espirometría; Spirometry; Spirometry quality; Telemedicina; Telemedicine