Camilo Barrera-Valencia1, Alexis Vladimir Benito-Devia2, Consuelo Vélez-Álvarez3, Mario Figueroa-Barrera4, Sandra Milena Franco-Idárraga3. 1. Grupo Telesalud, Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia. Electronic address: camilobarrera32@gmail.com. 2. Comité de Estudios Médicos CREIMED SAS, Medellín, Colombia. 3. Departamento de Salud Pública, Grupo de Investigación, Promoción de Salud y Prevención de la Enfermedad, Universidad de Caldas, Manizales, Colombia. 4. Departamento de Salud Mental, Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia.
Abstract
INTRODUCTION: Telepsychiatry is defined as the use of information and communication technology (ICT) in providing remote psychiatric services. Telepsychiatry is applied using two types of communication: synchronous (real time) and asynchronous (store and forward). OBJECTIVE: To determine the cost-effectiveness of a synchronous and an asynchronous telepsychiatric model in prison inmate patients with symptoms of depression. METHODS: A cost-effectiveness study was performed on a population consisting of 157 patients from the Establecimiento Penitenciario y Carcelario de Mediana Seguridad de Manizales, Colombia. The sample was determined by applying Zung self-administered surveys for depression (1965) and the Hamilton Depression Rating Scale (HDRS), the latter being the tool used for the comparison. RESULTS: Initial Hamilton score, arrival time, duration of system downtime, and clinical effectiveness variables had normal distributions (P>.05). There were significant differences (P<.001) between care costs for the different models, showing that the mean cost of the asynchronous model is less than synchronous model, and making the asynchronous model more cost-effective. CONCLUSIONS: The asynchronous model is the most cost-effective model of telepsychiatry care for patients with depression admitted to a detention centre, according to the results of clinical effectiveness, cost measurement, and patient satisfaction.
INTRODUCTION: Telepsychiatry is defined as the use of information and communication technology (ICT) in providing remote psychiatric services. Telepsychiatry is applied using two types of communication: synchronous (real time) and asynchronous (store and forward). OBJECTIVE: To determine the cost-effectiveness of a synchronous and an asynchronous telepsychiatric model in prison inmate patients with symptoms of depression. METHODS: A cost-effectiveness study was performed on a population consisting of 157 patients from the Establecimiento Penitenciario y Carcelario de Mediana Seguridad de Manizales, Colombia. The sample was determined by applying Zung self-administered surveys for depression (1965) and the Hamilton Depression Rating Scale (HDRS), the latter being the tool used for the comparison. RESULTS: Initial Hamilton score, arrival time, duration of system downtime, and clinical effectiveness variables had normal distributions (P>.05). There were significant differences (P<.001) between care costs for the different models, showing that the mean cost of the asynchronous model is less than synchronous model, and making the asynchronous model more cost-effective. CONCLUSIONS: The asynchronous model is the most cost-effective model of telepsychiatry care for patients with depression admitted to a detention centre, according to the results of clinical effectiveness, cost measurement, and patient satisfaction.
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