Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 20, 2022
Date Accepted: Nov 4, 2022
Date Submitted to PubMed: Nov 5, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Economic and Environmental Impact of Digital Health App Video Consultations in Follow-up Care for Patients in Orthopedic and Trauma Surgery in Germany: Randomized Controlled Trial
ABSTRACT
Background:
Following the Riyadh Declaration, the role of digital health was highlighted in coping with the COVID-19 pandemic. Telemedicine was encouraged in previously atypical clinical settings, such as follow-up care for patients in orthopedic and trauma surgery. Yet, health economic analyses of telemedicine grounded in clinical practice are still lacking and little is known of the effects on the environment and greenhouse gas emissions.
Objective:
This study aims to evaluate the economic and environmental effects of follow-up care by digital health app video consultation compared to conventional face-to-face (F2F) consultation for orthopedic and trauma surgery patients at a German university hospital.
Methods:
The health economic analysis was based on data from a randomized controlled trial that compared the use of video consultations with conventional F2F consultations in the follow-up care after knee and shoulder surgeries. Taking a societal perspective, we evaluated greenhouse gas emissions, environmental costs, travel costs, time costs and production losses.
Results:
Data from 52 patients indicated that, from the patients’ point of view, telemedicine helped to reduce travel costs, time costs, and production losses, resulting in mean cost savings of €76.52 per video consultation when compared with a F2F consultation. In addition, emissions of 11.248 kg of greenhouse gases, 0.070 kg of carbon monoxides, 0.011 kg of volatile hydrocarbons, 0.028 kg of nitrogen oxides, and 0.00004 kg of particulates could be saved per patient through avoided travel. This resulted in savings of environmental costs between €3.73 and €9.53 per patient.
Conclusions:
Telemedicine was found to reduce the carbon footprint and to save travel costs, travel time, and thus time costs, for patients, and it helped to lower production losses. These findings can support the decision-making on the utilization of telemedicine during and beyond the COVID-19 pandemic. Clinical Trial: German Register for Clinical Trials ID: DRKS00023445; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023445
Citation
