Telehealth substitution of rural outreach services: an economic analysis
Telehealth substitution of rural outreach services: an economic analysis Conference Paper
14th National Rural Health Conference: A World of Rural Health
- Author(s): Caffery, Liam, Hobbs, Aidan, Hale-Robertson, Karen, Smith, Anthony
- Secondary Author(s): Coleman, Leanne
- Published: 2017
- Publisher: National Rural Health Alliance
Abstract: Introduction: CheckUP, in partnership with the Queensland Aboriginal & Islander Health Council is the jurisdictional fund holder of the Commonwealth Government’s Outreach program funds that are used to provide a range of medical, allied health and nursing services to rural and remote communities and Aboriginal and Torres Strait Islander peoples. Currently, these services are provided by face-to-face outreach clinics. Telehealth is the delivery of health care at a distance using information and communication technologies. Many health care providers use telehealth as an alternative method of delivering health care services which traditionally may have only ever been available face-to-face. It is considered “best practice” to provide healthcare using a combination of face-to-face and telehealth as opposed to a complete replacement of face-to-face services. The suitability and proportion of telehealth substitution varies by specialty, complexity, and case mix. Telehealth may reduce the cost of health care provision when avoided travel costs associated with outreach services are considered. The aim of this study was to identify how CheckUP provided outreach services and costs may be affected through the substitution of these services with telehealth. Methods: We performed a cost comparison study where the actual costs of providing face-to-face outreach clinics were compared to a modelled cost of providing the same service using a blended face-to-face and telehealth service delivery model. We modelled seven clinician reimbursement models and three rates of telehealth substitution (25%, 50% and 75%). Models were stratified by health discipline. We modelled the 16 health disciplines that accounted for the top 50% of CheckUP services for both activity (number of visits) and cost of providing the service. Costs were reported from the perspective of CheckUP. Results: Thirteen of the sixteen health discipline services were less expensive to provide using a blended face-to-face / telehealth service model in at least one of the reimbursement models and telehealth substitution rate permutations. The resultant cost savings were observed to increase as the rate of telehealth substitution increased. The telehealth substitution rate at which costs savings were realised varied by discipline − some disciplines (e.g. GP, podiatry) realised savings at a 25% substitution rate whereas, other disciplines (e.g. physiotherapy, dermatology) only realised saving at a 75% substitution rate. Three disciplines never resulted in cost savings using telehealth substitution. Conclusion: Degree of substitutability of face-to-face services with telehealth, travel savings and cost of telecommunications required for a telehealth service need to be considered on a case-by-case basis to determine if telehealth will result in cost savings.
- Urls: http://www.ruralhealth.org.au/14nrhc/sites/default/files/Caffery%2C%20Liam_A2.pdf Available from, http://www.ruralhealth.org.au/14nrhc/program/concurrent-speakers Download site
- Publisher Location: Cairns