Abstract:
:The clinical effectiveness and costs of telemedicine in improving the referral process from primary to secondary care were examined in an eight-month prospective, comparative study with one-year follow-up. The internal-medicine outpatient clinics of two Finnish district hospitals were compared--Peijas Hospital (PH) with telemedicine and Hyvinkää Hospital (HH) without it. The three primary-care centres studied referred a total of 292 adult patients to the outpatient clinics. The population-based number of referrals to PH (7.5/1000) from primary-care centres was twice that to HH (3.8/1000). Thirty-seven per cent of referrals to PH included requests from general practitioners for on-line medical advice (teleconsultation). Forty-three per cent of the total number of intranet referrals resulted in outpatient visits at PH, compared with 79% in the outpatient clinic at HH. Only 18% of the patients receiving a teleconsultation ended up in the outpatient department of PH within one year. These visits were mainly due to progression of chronic disease. No deaths or missed diagnoses could be attributed to telemedicine, but one diagnosis was delayed. The direct costs of an outpatient clinic visit in internal medicine (EU211) were seven times greater per patient than for an e-mail consultation (EU32), with a marginal cost decrease of EU179 for every new intranet consultation. A cost-minimization analysis of the alternative interventions showed a net benefit of EU7876 in favour of the teleconsultation process. General practitioners sought an outpatient visit for 130 of their patients, and advice only for another 77. On-line advice was nonetheless given in 108 cases, and only 88 patient visits were arranged. Eleven referrals were declined. The cost difference between giving on-line medical advice for the 108 cases and a visit to the outpatient clinic for the other 88 was less costly (by EU4140) than investigating the 124 patients whose original clinic referrals to the PH were not declined. Productivity in the hospital increased over threefold by using e-mail consultations instead of traditional outpatient visits. The wide interactive use of the intranet referral system between secondary and primary care improved clinical effectiveness, lowered direct costs, increased productivity and was cost-effective.
journal_name
J Telemed Telecarejournal_title
Journal of telemedicine and telecareauthors
Harno K,Paavola T,Carlson C,Viikinkoski Pdoi
10.1258/1357633001935996subject
Has Abstractpub_date
2000-01-01 00:00:00pages
320-9issue
6eissn
1357-633Xissn
1758-1109journal_volume
6pub_type
杂志文章abstract::Well-implemented telehealth systems can reduce the total costs of care by reducing emergency hospital visits and unnecessary treatment. Telehealth is especially well-suited to supporting patients with chronic, complex or co-morbid conditions. A substantial body of research--much from the USA--documents the value of a ...
journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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abstract:INTRODUCTION:Telehealth technologies for rural patients are increasingly being used to deliver care within the Department of Veterans Affairs (VA), and treatment of hepatitis C virus (HCV) is no exception. However, data evaluating outcomes with telehealth compared with specialty clinics in the era of direct-acting anti...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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更新日期:2011-01-01 00:00:00
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章,评审
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-01-01 00:00:00
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journal_title:Journal of telemedicine and telecare
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更新日期:2012-03-01 00:00:00
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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journal_title:Journal of telemedicine and telecare
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abstract:INTRODUCTION:Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to be efficacious for chronic tic disorders (CTDs), but utilization is limited by a lack of treatment providers and perceived financial and time burden of commuting to treatment. A promising alternative to in-person delivery is voice over...
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