Economic Assessment and Budgetary Impact of a Telemedicine Procedure and Spirometry Quality Control in the Primary Care Setting

Objective: To evaluate the economic impact of a telemedicine procedure designed to improve the quality of lung function testing (LET) in primary care in a public healthcare system, compared with the standard method. Materials and Methods: The economic impact of 9039 LFTs performed in 51 health centers (2010-2013) using telespirometry (TS) compared to standard spirometry (SS) was studied. Results: TS costs more per unit than SS ((sic)47.80 vs (sic)39.70) (2013), but the quality of the TS procedure is superior (84% good quality, compared to 61% using the standard procedure). Total cost of TS was (sic)431974 (compared with (sic)358306 for SS), generating an economic impact of (sic)73668 (2013). The increase in cost for good quality LFT performed using TS was (sic)34030 (2010) and (sic)144295 (2013), while the costs of poor quality tests fell by (sic)15525 (2010) and 70627(sic) (2013). Conclusion: The cost-effectiveness analysis concludes that TS is 23% more expensive and 46% more effective. Healthcare costs consequently fall as the number of LFTs performed by TS rises. Avoiding poor quality, invalid LFTs generates savings that compensate for the increased costs of performing LFTs with TS, making it a cost-effective method. (C) 2014 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.