Economic evaluation of teleinterconsultations offered by the BP’s TeleNordeste Project: micro-costing study
DOI:
https://doi.org/10.21115/JBES.v17.p51-8Keywords:
Telemedicine,, Cost Savings, Costs and Cost AnalysisAbstract
Introduction: Telehealth aims to reduce costs related to the provision of health care, promote more efficient use of human resources, and improve timely and equitable access to health care. Objective: The objective of this study is to present the analysis of the estimated costs involved in the specialized care model through triangulated teleinterconsultation between a focal specialist physician, primary care physicians, and patient, developed by the Hospital Beneficência Portuguesa de São Paulo (BP) through the BP’s TeleNordeste Project. Methods: Microcosting study of teleconsultations carried out through the BP’s TeleNordeste Project using the Time-Driven Activity-Based Costing (TDABC) method, from the perspective of the Hospital de Excelência, a member of PROADI-SUS. The analysis was carried out from January to December 2024. The analysis was structured according to da Silva Etges’ proposal through eight steps to implement activity-based costing for health services, Results: A median cost of R$ 132,50 per teleconsultation as a standard target in the scenario with full installed capacity (best case scenario) was established as a reference. During the execution of the project in 2024, the median cost was R$ 154.50 per teleconsultation. Conclusion: The analysis of the costs involved in offering teleinterconsultations by the BP’s TeleNordeste Project is highly relevant information for the development of public policies for the Sistema Único de Saúde involving telehealth.
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References
AQUINO, E. R. D. S. et al. Teleconsultations in neurology in a universal health system amid COVID-19: a descriptive study. Revista da Associação Médica Brasileira, v. 68, n. 10, p. 1376–1382, out. 2022.
CONSTANZO, F. et al. Contribution of a synchronic teleneurology program to decrease the patient number waiting for a first consultation and their waiting time in Chile. BMC Medical Informatics and Decision Making, v. 20, n. 1, p. 20, dez. 2020.
DA SILVA ETGES, A. P. B. et al. An 8-step framework for implementing time-driven activity-based costing in healthcare studies. The European Journal of Health Economics, v. 20, n. 8, p. 1133–1145, nov. 2019.
DAS, N. et al. Absenteeism and presenteeism among caregivers of chronic diseases: A systematic review and meta-analysis. Social Science & Medicine, v. 363, p. 117375, dez. 2024.
FERNANDES, B. S. D. A. et al. Chronic noncommunicable diseases and absenteeism from work: National Survey of Health, 2019. Revista Brasileira de Epidemiologia, v. 27, p. e240061, 2024.
GIOVANELLA, L. et al. Saúde da família: limites e possibilidades para uma abordagem integral de atenção primária à saúde no Brasil. Ciência & Saúde Coletiva, v. 14, n. 3, p. 783–794, jun. 2009.
INSTITUTO BRASILEIRO DE GEOGRAFIA E ESTATISTICA - IBGE. Brasil em Síntese. 2024.
JACOBS, J. C. et al. Virtual Savings: Patient-Reported Time and Money Savings from a VA National Telehealth Tablet Initiative. Telemedicine and e-Health, v. 26, n. 9, p. 1178–1183, 1 set. 2020.
JIANG, S. et al. Incorporating productivity loss in health economic evaluations: a review of guidelines and practices worldwide for research agenda in China. BMJ Global Health, v. 7, n. 8, p. e009777, ago. 2022.
KAPLAN, R. S.; ANDERSON, S. R. Time-Driven Activity-Based Costing. [s.d.].
LIMA, S. G. G.; BRITO, C. D.; ANDRADE, C. J. C. D. O processo de incorporação de tecnologias em saúde no Brasil em uma perspectiva internacional. Ciência & Saúde Coletiva, v. 24, n. 5, p. 1709–1722, maio 2019.
MENDES, EUGÊNIO VILAÇA. Desalios do SUS/ Eugênio Vilaça Mendes. CONASS. Brasília, DF: [s.n.].
MORI, N. L. R. et al. Resolution, access, and waiting time for specialties in different models of care. Revista de Saúde Pública, v. 54, p. 18, 28 jan. 2020.
NIZAR, N. A. et al. Patient cost analysis of a community-based teledermatology service versus conventional outpatient appointments in East Kent: a retrospective study through a societal lens to reduce health inequalities. BMC Health Services Research, v. 24, n. 1, p. 1632, 21 dez. 2024.
PADILHA, F. V. D. Q. et al. Análise dos custos da teleconsulta para tratamento de diabetes mellitus no SUS. Revista de Saúde Pública, v. 58, n. 1, p. 15, 12 abr. 2024.
PATEL, K. B. et al. Estimated Carbon Emissions Savings With Shifts From In-Person Visits to Telemedicine for Patients With Cancer. JAMA Network Open, v. 6, n. 1, p. e2253788, 31 jan. 2023.
PUROHIT, A.; SMITH, J.; HIBBLE, A. Does telemedicine reduce the carbon footprint of healthcare? A systematic review. Future Healthcare Journal, v. 8, n. 1, p. e85–e91, mar. 2021.
RODLER, S. et al. The Impact of Telemedicine in Reducing the Carbon Footprint in Health Care: A Systematic Review and Cumulative Analysis of 68 Million Clinical Consultations. European Urology Focus, v. 9, n. 6, p. 873–887, nov. 2023.
ROJANASAROT, S.; BHATTACHARYYA, S. K.; EDWARDS, N. Productivity loss and productivity loss costs to United States employers due to priority conditions: a systematic review. Journal of Medical Economics, v. 26, n. 1, p. 262–270, 31 dez. 2023.
SCHMITZ-GROSZ, K. et al. A Telemedicine Center Reduces the Comprehensive Carbon Footprint in Primary Care: A Monocenter, Retrospective Study. Journal of Primary Care & Community Health, v. 14, p. 21501319231215020, jan. 2023.
SNOSWELL, C. L. et al. A cost-consequence analysis comparing patient travel, outreach, and telehealth clinic models for a specialist diabetes service to Indigenous people in Queensland. Journal of Telemedicine and Telecare, v. 25, n. 9, p. 537–544, out. 2019.
STARFIELD, B. Primary care: balancing health needs, services, and technology. Rev. ed ed. New York: Oxford University Press, 1998.
THOMAZ,RP et al. Equity of Access to Palliative Care Through Telehealth: Experience Report. Am J Hosp Palliat Med, 8 maio 2025.
THOTA, R. et al. Telehealth Is a Sustainable Population Health Strategy to Lower Costs and Increase Quality of Health Care in Rural Utah. JCO Oncology Practice, v. 16, n. 7, p. e557–e562, jul. 2020.
WADE, V. A. et al. A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Services Research, v. 10, n. 1, p. 233, dez. 2010.
ZANOTTO, B. S. et al. Avaliação Econômica de um Serviço de Telemedicina para ampliação da Atenção Primária à Saúde no Rio Grande do Sul: o microcusteio do Projeto TeleOftalmo. Ciência & Saúde Coletiva, v. 25, n. 4, p. 1349–1360, abr. 2020.
