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Teleconsultation in remote care stations: Cost-Minimisation analysis of the Guianese experiment

Author

Listed:
  • Myriam Le Goff-Pronost

    (CREM - Centre de recherche en économie et management - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UR - Université de Rennes - CNRS - Centre National de la Recherche Scientifique, LUSSI - Département Logique des Usages, Sciences sociales et Sciences de l'Information - UEB - Université européenne de Bretagne - European University of Brittany - Télécom Bretagne - IMT - Institut Mines-Télécom [Paris])

  • Nabil Nassiri

    (ICI - Laboratoire Information, Coordination, Incitations - UEB - Université européenne de Bretagne - European University of Brittany - UBO - Université de Brest - Télécom Bretagne - IMT - Institut Mines-Télécom [Paris] - IBSHS - Institut Brestois des Sciences de l'Homme et de la Société - UBO - Université de Brest)

  • Abdelhak Nassiri

    (ICI - Laboratoire Information, Coordination, Incitations - UEB - Université européenne de Bretagne - European University of Brittany - UBO - Université de Brest - Télécom Bretagne - IMT - Institut Mines-Télécom [Paris] - IBSHS - Institut Brestois des Sciences de l'Homme et de la Société - UBO - Université de Brest)

Abstract

The aim of the paper is to carry out a cost-minimisation analysis in order to measure the cost saving performances of teleconsultation in Guiana. A prospective analysis lasting 6 months of all admissions for three pathologies (cardiology, parasitology, dermatology) at four care stations in Guiana (Saint Georges, Trois Sauts, Maripasoula and Anticum pata). A cost-minimisation analysis is carried out to compare teleconsultation with air medical evacuations. Fixed and variable costs are estimated in order to identify the break-even point of teleconsultation. Estimations are done at two levels: aggregate level where the four stations are considered jointly, and disaggregate level where these stations are assumed to be separable. It also takes into account organisational and quality effects. If the four stations are considered jointly, the break-even point is 12.67 (Investments are assumed to last 6 years). This means that teleconsultation permits savings on air medical evacuation costs if thirteen evacuations are avoided each year inseparably at the four stations. We deduce a reference threshold for each station whose value is 3.17. If stations are analysed separately, the most efficient station is Trois Sauts with the lowest break-even point, 2.98. Saint Georges is the worst, 4.31, and suffers from organisational problems caused by personnel turnover which inflate costs of teleconsultation by about 35.96%. Our main question is whether teleconsultation is cost saving and our response is based on the comparison of break-event points with the number of air medical evacuations actually avoided during the period. At the aggregate level of the four stations, teleconsultation is not cost saving as only three evacuations were actually prevented. However, these evacuations were avoided in Trois Sauts. Regarding its break-even point, 2.98, we note that teleconsultation is already a promising option and permits savings.

Suggested Citation

  • Myriam Le Goff-Pronost & Nabil Nassiri & Abdelhak Nassiri, 2009. "Teleconsultation in remote care stations: Cost-Minimisation analysis of the Guianese experiment," Post-Print halshs-00486278, HAL.
  • Handle: RePEc:hal:journl:halshs-00486278
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