Bedside ROP screening and telemedicine interpretation integrated to a neonatal transport system: Economic aspects and return on investment analysis.
Peter Cerny Ambulance Service - Premature Eye Rescue Program (PCA-PERP) uses digital retinal imaging (DRI) with remote interpretation in bedside ROP screening, which has advantages over binocular indirect ophthalmoscopy (BIO) in screening of premature newborns. We aimed to demonstrate that PCA-PERP provides good value for the money and to model the cost ramifications of a similar newly launched system.



As DRI was demonstrated to have high diagnostic performance, only the costs of bedside DRI-based screening were compared to those of traditional transport and BIO-based screening (cost-minimization analysis). The total costs of investment and maintenance were analyzed with micro-costing method. A ten-year analysis time-horizon and service provider's perspective were applied.



From the launch of PCA-PERP up to the end of 2014, 3722 bedside examinations were performed in the PCA covered central region of Hungary. From 2009 to 2014, PCA-PERP saved 92,248km and 3633 staff working hours, with an annual nominal cost-savings ranging from 17,435 to 35,140 Euro. The net present value was 127,847 Euro at the end of 2014, with a payback period of 4.1years and an internal rate of return of 20.8%. Our model presented the NPVs of different scenarios with different initial investments, annual number of transports and average transport distances.



PCA-PERP as bedside screening with remote interpretation, when compared to a transport-based screening with BIO, produced better cost-savings from the perspective of the service provider and provided a return on initial investment within five years after the project initiation.
Peter Cerny Foundation for Curing Sick Babies, Budapest, Hungary; Syreon Research Institute, Mexikói Way 65a, Budapest 1145, Hungary. Electronic address: gabor.kovacs@cerny.hu.
Gábor
G
Kovács
Peter Cerny Foundation for Curing Sick Babies, Budapest, Hungary. Electronic address: somogyvari@cerny.hu.
Zsolt
Z
Somogyvári
Semmelweis University, Department of Ophthalmology, Mária street 39, Budapest 1085, Hungary. Electronic address: dr.maka.erika@gmail.com.
Erika
E
Maka
Syreon Research Institute, Mexikói Way 65a, Budapest 1145, Hungary. Electronic address: laszlonagyjanosi@gmail.com.
László
L
Nagyjánosi
D000552:Ambulances / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D006814:Hungary; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D000067716:Point-of-Care Testing / Q000191:economics*; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000191:economics; D017216:Telemedicine / Q000191:economics / Q000379:methods*
Bedside screening; Cost-minimization analysis; Digital retinal imaging; Retinopathy of prematurity; Telemedicine