Journal of telemedicine and telecare
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We examined the activity (services recorded) and cost (benefits paid) of reimbursement associated with telepsychiatry services in the Australian public health-care sector. We reviewed the activity and costs administered through the government's Medicare Benefits Schedule (MBS) from July 2002 to June 2011. ⋯ Of these, 8003 were telepsychiatry consultations which cost $934,000, i.e. the video consultations subgroup represented 0.06% of all psychiatric consultations provided and 0.06% of the total cost to the government for these services. Despite telepsychiatry being a widely reported and successful example of telehealth internationally, the uptake of telepsychiatry in Australia has been slow.
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A systematic review of studies of the cost-effectiveness of telemedicine and telecare was undertaken from 1990 until September 2010. Twelve databases were searched, using economic evaluation terms combined with telemedicine terms. The search identified 80 studies which were classed as full economic evaluations; the majority (38) were cost-consequence analyses. ⋯ Eleven were CEA and seven were CUA. Economic tools are being increasingly used for telemedicine and telecare studies, although better reporting of the methodologies and findings of the economic evaluations is required. Nonetheless, the results of the review were consistent with previous findings, i.e. there is no further conclusive evidence that telemedicine and telecare interventions are cost-effective compared to conventional health care.
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Patients failing to attend hospital appointments contribute to inefficient use of resources. We conducted a systematic review of studies providing a reminder to patients by phone, short message service (SMS) or automated phone calls. A PubMed search was conducted to identify articles published after 1999, describing studies of non-attendance at hospital appointments. ⋯ Cost and savings were not measured formally in any of the papers, but almost half of them included cost estimates. The average cost of using either SMS, automated phone calls or phone calls was €0.41 per reminder. Although formal evidence of cost-effectiveness is lacking, the implication of the review is that all hospitals should consider using automated reminders to reduce non-attendance at appointments.
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We investigated the factors that affected the use of a realtime telemetry system (RTS) in emergency ambulances. During the study, a total of 7144 patients were transported to a hospital in the city of Wonju via ambulance. In 466 of these cases (7%), the Emergency Medical Technician (EMT) used the RTS. ⋯ The results indicated that EMTs with higher levels of expertise were more likely to use the RTS when the level of patient consciousness was low, regardless of transport time. Conversely, EMTs with low levels of expertise were more likely to use the RTS when the transport time from scene to hospital was long and were less likely to use the RTS when the transport time was short. There appear to be several ways of improving RTS usage in the pre-hospital situation.