6049
document
A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care : an urban versus rural perspective . A randomized controlled trial was carried out to measure the cost-effectiveness of realtime teledermatology compared with conventional outpatient dermatology care for patients from urban and rural areas . One urban and one rural health centre were linked to a regional hospital in Northern Ireland by ISDN at 128 kbit/s . Over two years , 274 patients required a hospital outpatient dermatology referral -- 126 patients ( 46 % ) were randomized to a telemedicine consultation and 148 ( 54 % ) to a conventional hospital outpatient consultation . Of those seen by telemedicine , 61 % were registered with an urban practice , compared with 71 % of those seen conventionally . The clinical outcomes of the two types of consultation were similar -- almost half the patients were managed after a single consultation with the dermatologist . The observed marginal cost per patient of the initial realtime teledermatology consultation was 52.85 Pounds for those in urban areas and 59.93 Pounds per patient for those from rural areas . The observed marginal cost of the initial conventional consultation was 47.13 Pounds for urban patients and 48.77 Pounds for rural patients . The total observed costs of teledermatology were higher than the costs of conventional care in both urban and rural areas , mainly because of the fixed equipment costs . Sensitivity analysis using a real-world scenario showed that in urban areas the average costs of the telemedicine and conventional consultations were about equal , while in rural areas the average cost of the telemedicine consultation was less than that of the conventional consultation .
6050
Intervention_Physical
realtime teledermatology
6051
Intervention_Physical
conventional care
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Intervention_Other
realtime teledermatology
6053
Intervention_Control
conventional outpatient dermatology care
6054
Intervention_Educational
telemedicine consultation
6055
Intervention_Educational
conventional hospital outpatient consultation
6056
Intervention_Other
telemedicine
6057
Intervention_Educational
conventionally
6058
Intervention_Physical
realtime teledermatology consultation
6059
Intervention_Educational
conventional consultation
6060
Intervention_Physical
teledermatology
6061
Intervention_Physical
conventional care
6062
Intervention_Other
telemedicine
6063
Intervention_Physical
conventional consultations
6064
Intervention_Physical
telemedicine consultation
6065
Intervention_Physical
conventional consultation
6066
Outcome_Other
health economics of realtime teledermatology
6067
Outcome_Other
cost-effectiveness of realtime teledermatology
6068
Outcome_Physical
clinical outcomes
6069
Outcome_Other
consultation
6070
Outcome_Other
observed marginal cost per patient
6071
Outcome_Other
observed marginal cost
6072
Outcome_Other
total observed costs
6073
Outcome_Other
average costs
6074
Participant_Sample-size
274
6075
Participant_Sample-size
126