July 2003
From BMJ-British Medical Journal
Virtual consultations are not cost effective Virtual outreach: economic evaluation of joint teleconsultations for patients referred by their general practitioner for a specialist opinion BMJ Volume 327, pp 84-8 Virtual consultations between doctors and patients cost the NHS more than standard outpatient appointments, but are slightly less time consuming and cheaper for patients, conclude researchers in this week's BMJ.A videoconferencing link was set up at two hospitals and 29 general practices in the UK to allow consultations between the general practitioner, present with the patient in the practice, and consultants in the hospital. A total of 1,051 patients were allocated to virtual outreach consultations and 1,043 to standard outpatient appointments. Over six months, costs were greater for the virtual outreach consultations (�724 per patient) than for conventional outpatient appointments (�625 per patient). Patients attending a teleconsultation incurred significantly lower transport costs and less time off work than those attending conventional outpatient appointments, although the cost difference (�3) was relatively small. Considering total costs, widespread adoption of virtual outreach cannot be justified on economic grounds, say the authors although the use of patient selection in certain specialties could improve its relative cost effectiveness. Furthermore, a six-month follow up period may have been too short to detect all 'downstream' savings and improved patient satisfaction was not taken into account. "We may therefore have underestimated the beneficial consequences of virtual outreach," they conclude. |