title: Opportunity cost of the dermatologist's consulting time in the economic evaluation of teledermatology.
abstract: Introduction This study, through a systematic review and meta-analysis, has sought to demonstrate that the opportunity cost is a value to take into account in studies of economic cost in telemedicine, illustrated through the time of the dermatologist's consultation in teledermatology and traditional consultation. Methods Economic evaluation studies have been identified that compare teledermatology and traditional dermatological consultation during the period 1998-2015. We carried out a meta-analysis considering the work cost and the dermatologist's consultation time, analysing their differences. The opportunity cost represented by these differences in the dermatological remote consultation time was subsequently calculated based on the design of a cost/time variable. Results It was not possible to meta-analyse the cost of the dermatologist's consultation due to insufficient standardized complete data. It was possible to carry out a meta-analysis of the consultation time, and three articles were selected (2945 patients). Teledermatology accounts for more time (7.54 min) than conventional consultation ( p < 0.00001) and this difference is an opportunity cost of teledermatology of €29.25 per each remote consultation, with a unitary factor cost/time of 3.88€/minute. Conclusions There is no unanimity in the literature regarding which of the two procedures is cheaper; further studies with the necessary standardized variables are required. In this meta-analysis, teledermatology takes more time than a conventional dermatology consultation, which leads to an opportunity cost, increasing the total cost of consultation. The opportunity cost is a value that should be included in an analysis of economic costs, in the context of an economic assessment, when we evaluate a health activity.
authors.affiliation: 1 Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fuertes-Guiró
authors.affiliation: 2 Department of Statistics, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Girabent-Farrés
mesh_terms: D003362:Cost-Benefit Analysis; D000072085:Dermatologists / Q000191:economics / Q000458:organization & administration*; D003880:Dermatology / Q000191:economics / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D018803:Models, Economic; D019114:Remote Consultation / Q000191:economics / Q000458:organization & administration*; D013997:Time Factors
keywords: Opportunity cost; economic evaluation; teledermatology; time of consulting