BACKGROUND: Telecardiology is a tool that can aid in cardiovascular care, mainly in towns located in remote areas. However, economic assessments on this subject are scarce and have yielded controversial results. OBJECTIVE: To evaluate the cost-benefit of implementing a Telecardiology service in remote, small towns in the state of Minas Gerais, Brazil. METHODS: The study used the database from the Minas Telecardio (MTC) Project, developed from June 2006 to November 2008, in 82 towns in the countryside of the state. Each municipality received a microcomputer with a digital electrocardiograph, with the possibility of transmitting ECG tracings and communicating with the on-duty cardiologist at the University hospital. The cost-benefit analysis was carried out by comparing the cost of performing an ECG in the project versus the cost of performing it by patient referral to another city. RESULTS: The average cost of an ECG in the MTC project was R$ 28.92, decomposed into R$ 8.08 for the cost of implementation and R$ 20.84 for maintenance. The cost simulation of the ECG with referral ranged from R$ 30.91 to R$ 54.58, with the cost-benefit ratio being always favorable to the MTC program, regardless of the type of calculation used for referral distance. The simulations considered the financial sponsor's and society's points-of-view. The sensitivity analysis with variation of calibration parameters confirmed these results. CONCLUSION: The implementation of a Telecardiology system as support to primary care in small Brazilian towns is feasible and economically beneficial, and can be used as a regular program within the Brazilian public health system.
BACKGROUND: Telecardiology is a tool that can aid in cardiovascular care, mainly in towns located in remote areas. However, economic assessments on this subject are scarce and have yielded controversial results. OBJECTIVE: To evaluate the cost-benefit of implementing a Telecardiology service in remote, small towns in the state of Minas Gerais, Brazil. METHODS: The study used the database from the Minas Telecardio (MTC) Project, developed from June 2006 to November 2008, in 82 towns in the countryside of the state. Each municipality received a microcomputer with a digital electrocardiograph, with the possibility of transmitting ECG tracings and communicating with the on-duty cardiologist at the University hospital. The cost-benefit analysis was carried out by comparing the cost of performing an ECG in the project versus the cost of performing it by patient referral to another city. RESULTS: The average cost of an ECG in the MTC project was R$ 28.92, decomposed into R$ 8.08 for the cost of implementation and R$ 20.84 for maintenance. The cost simulation of the ECG with referral ranged from R$ 30.91 to R$ 54.58, with the cost-benefit ratio being always favorable to the MTC program, regardless of the type of calculation used for referral distance. The simulations considered the financial sponsor's and society's points-of-view. The sensitivity analysis with variation of calibration parameters confirmed these results. CONCLUSION: The implementation of a Telecardiology system as support to primary care in small Brazilian towns is feasible and economically beneficial, and can be used as a regular program within the Brazilian public health system.
Authors: Rashid L Bashshur; Gary W Shannon; Brian R Smith; Dale C Alverson; Nina Antoniotti; William G Barsan; Noura Bashshur; Edward M Brown; Molly J Coye; Charles R Doarn; Stewart Ferguson; Jim Grigsby; Elizabeth A Krupinski; Joseph C Kvedar; Jonathan Linkous; Ronald C Merrell; Thomas Nesbitt; Ronald Poropatich; Karen S Rheuban; Jay H Sanders; Andrew R Watson; Ronald S Weinstein; Peter Yellowlees Journal: Telemed J E Health Date: 2014-06-26 Impact factor: 3.536
Authors: Maria Beatriz Alkmim; Renato Minelli Figueira; Milena Soriano Marcolino; Clareci Silva Cardoso; Monica Pena de Abreu; Lemuel Rodrigues Cunha; Daniel Ferreira da Cunha; Andre Pires Antunes; Adélson Geraldo de A Resende; Elmiro Santos Resende; Antonio Luiz Pinho Ribeiro Journal: Bull World Health Organ Date: 2012-05-01 Impact factor: 9.408
Authors: Bruno R Nascimento; Craig Sable; Maria Carmo P Nunes; Adriana C Diamantino; Kaciane K B Oliveira; Cassio M Oliveira; Zilda Maria A Meira; Sandra Regina T Castilho; Júlia P A Santos; Letícia Maria M Rabelo; Karlla C A Lauriano; Gabriel A L Carmo; Allison Tompsett; Antonio Luiz P Ribeiro; Andrea Z Beaton Journal: J Am Heart Assoc Date: 2018-02-14 Impact factor: 5.501