Economic impact of outpatient follow-up using telemedicine vs in-person visits for patients in general surgery: A secondary analysis of a randomized clinical trial

Georgina Ferret; Manel Cremades; Lídia Cornejo; Francesc Guillem-López; Ramon Farrés; David Parés; Joan-Francesc Julian

doi:10.1016/j.cireng.2024.01.015

Economic impact of outpatient follow-up using telemedicine vs in-person visits for patients in general surgery: A secondary analysis of a randomized clinical trial

Cir Esp (Engl Ed). 2024 Apr 9:S2173-5077(24)00085-1. doi: 10.1016/j.cireng.2024.01.015. Online ahead of print.

Authors

Georgina Ferret¹, Manel Cremades², Lídia Cornejo¹, Francesc Guillem-López², Ramon Farrés¹, David Parés³, Joan-Francesc Julian²

Affiliations

¹ Department of General Surgery, Hospital Universitari Doctor Josep Trueta, Avda. França s/n, 17007 Girona, Spain.
² Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain.
³ Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain. Electronic address: davidpares.germanstrias@gencat.cat.

PMID: 38604567
DOI: 10.1016/j.cireng.2024.01.015

Abstract

Introduction: Innovation in internet connectivity and the Covid 19 pandemic have caused a dramatic change in the management of patients in the medical field, boosting the use of telemedicine. A comparison of clinical outcomes and satisfaction between conventional face-to-face and telemedicine follow-up in general surgery, an economic evaluation is mandatory. The aim of the present study was to compare the differences in economic costs between these two outpatient approaches in a designed randomized controlled trial (RCT).

Methods: A RCT was conducted enrolling 200 patients to compare conventional in-person vs. digital health follow-up using telemedicine in the outpatient clinics in patients of General Surgery Department after their planned discharge. After a demonstration that no differences were found in clinical outcomes and patient satisfaction, we analyzed the medical costs, including staff wages, initial investment, patent's transportation and impact on social costs.

Results: After an initial investment of 7527.53€, the costs for the Medical institution of in-person conventional follow-up were higher (8180.4€) than those using telemedicine (4630.06€). In relation to social costs, loss of productivity was also increased in the conventional follow-up.

Conclusion: The use of digital Health telemedicine is a cost-effective approach compared to conventional face-to-face follow-up in patients of General Surgery after hospital discharge.

Keywords: Cirugía General; Cost-effective study; Estudio económico; Follow-up, Randomized controlled trial; General surgery; Seguimiento, Ensayo clínico aleatorizado; Telemedicina; Telemedicine.