Principal Results
trauma
This health economic analysis from a health provider’s perspective showed important insights for stakeholder decision-making on the long-term use of telemedicine in the follow-up care of patients in orthopedic and trauma surgery by examining both the suitability of video consultations and the associated financial and personnel effects.The results of the TSQ indicated that the majority of patients positively evaluated the physician-patient communication and service provided through video consultations. These results are similar to findings in other surgical specialties [Although video consultations were 25% (2.69/10.92 minutes) shorter than F2F consultations, there was no significant difference in patient utility regarding health-related quality of life between the telemedicine group and the control group. In a former study, we already compared the EQ-visual analog scale between the intervention and the control group [From the health provider’s perspective, these results suggest that video consultations might be suitable for use in orthopedic and trauma surgery. The potential of video consultations is further underlined by previous studies that found comparable results to F2F consultations in terms of physician and patient satisfaction, efficiency, quality of care, and benefits from a societal perspective [The economic impact of using telemedicine can be differentiated for clinics both as providers of medical services and as employers. As providers of medical services, clinics benefit from productivity gains due to a reduced consultation time, which on the one hand could lead to lower personnel costs and thus relieve the burden on the health care system, and on the other hand could result in an increased capacity of a clinic and thus improve patient care through shorter waiting times and mitigate the shortage of physicians in the health care system [A holistic view of the economic effects of telemedicine, however, must consider not only the cost savings but also the additional costs incurred by the clinic as a result of the technology.A minimum of 23 video consultations per physician per month was required to recoup the costs of investing in telemedicine software through a reduction in personnel costs resulting from time savings. In the sensitivity analysis, the break-even point ranged from 11.54 to 37.92 video consultations. A lower software fee, however, effectively capped the number of video consultations at 20 per month. Whether this is a viable option for decision makers in practice depends on their individual objectives. Competing providers of telemedicine software in Germany may well offer lower fees that would help lower the break-even point. A given hospital’s possibility of negotiating individual terms of use and fee structures with telemedicine providers might be another important aspect to take into account when implementing telemedicine. Finally, physicians’ incomes are rising continuously. The calculations of personnel costs were based on the cost rates in effect at the time the study was conducted. In 2023, salaries will increase by up to 5.13%. The savings of higher personnel costs through telemedicine will then be accompanied by a lower break-even point. The break-even points calculated in earlier contributions by Buvik et al [This health economic evaluation provides clinical evidence on the apparent ability of telemedicine to provide similar patient utility at lower cost and can therefore improve stakeholders’ decisions on implementing telemedicine in the follow-up care of patients in orthopedic and trauma surgery both in and beyond the current COVID-19 pandemic [