Telemedicine Consultations: Reduce Neonatal Care Transfers

For a study, researchers sought to conduct an economic evaluation to estimate the return on investment (ROI) of making telemedicine consultations available from the perspective of healthcare payers, as well as to estimate the economic impacts of telemedicine under a hypothetical scenario in which all rural hospitals in California providing level I neonatal care had access to telemedicine consultations from neonatologists at level III and level IV neonatal intensive care units (NICUs). They created standard decision models using assumptions taken from primary data and the literature. Telemedicine expenditures included equipment installation and operation. To address model uncertainties and establish 95% probabilistic confidence intervals, a probabilistic analysis with Monte Carlo simulation was done (PCIs). The Consumer Price Index was used to convert all expenditures to 2017 US dollars. 

According to the probabilistic study, the ROI has a mean value of 2.23 (95% PCI, 0.7 to 6.0). That is, a $1 investment in this telemedicine paradigm would result in a $1.23 net medical cost savings. About 75% of the hypothetical 1,000 Monte Carlo runs showed “cost savings.” The predicted mean yearly net savings for the state of California were $661,000.

By minimizing possibly needless transfers of babies to level III and IV NICUs, offering telemedicine and making consultations available to remote hospitals providing level I neonatal care was anticipated to minimize medical expenditures, covering all telemedicine-related expenses.

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