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International Journal for Quality in Health Care Advance Access published online on September 6, 2005
International Journal for Quality in Health Care, doi:10.1093/intqhc/mzi075
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International Journal for Quality in Health Care © The Author 2005. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Accepted August 5, 2005

Articles

Cost-minimization analysis of a wide-area teleradiology network in a French region

Valentin Daucourt 1*, Claude Sicotte 2, Nathalie Pelletier-Fleury 3, Marie-Edith Petitjean 4, Jean-François Chateil 5, and Philippe Michel 1

1 Committee for clinical evaluation and quality improvement in Aquitaine, Xavier Arnozan Hospital, Pessac, France
2 Interdisciplinary Health Research Group (GRIS), Department of Health Administration, University of Montreal, Québec, Canada
3 INSERM U537, Center for Health Economics and Administration Research, Bicetre Hospital, Paris
4 Emergency Department, Pellegrin University Hospital, Bordeaux, France
5 Unit of Radiology, Pellegrin-Children’s University Hospital, Bordeaux, France

* To whom correspondence should be addressed.
Valentin Daucourt, E-mail: valentin.daucourt{at}ccecqa.asso.fr


  Abstract

Objective. The objective of our study was to perform a cost-minimization analysis of a wide-area teleradiology network.

Design. A prospective analysis of all transmissions over 1 year (data transmitted at the time of the remote consultation, and health outcomes of patients from medical record).

Intervention. The inter-hospital teleradiology network of the Aquitaine area (RIHRA) is a telemedicine system enabling the management of remote emergencies and elective radiology consultations.

Main outcome measure. A cost-minimization study enabled a comparison of care procedures following the use of the network with those which would have been implemented without the network. The outcome measures of effectiveness were the transfers, hospitalizations, and consultations avoided or added. Fixed and variable costs were estimated.

Results. Among the 664 transmissions included in the study, 562 (85%) were performed in emergency and 102 (15%) for elective (non-emergency) cases. In emergency, 48% of transfers were avoided. For elective teleconsultations, a transfer was avoided for 37% of the patients and hospitalization for 12%. An extra consultation occurred after remote consultation for 2% of the patients. Annual saving can be estimated at 102 779 EUR for the Aquitaine area.

Conclusions. This study underlines the efficiency of an inter-hospital teleradiology network. A qualitative evaluation of the impact of the use of the system should be carried out to improve technical and organizational operations.

Keywords: cost-minimization analysis, costs, evaluation studies, technology assessment, telemedicine, teleradiology.
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