Table 6.
System-level cost implications of standard care versus telehealth.
| Cost estimatesa | |||
|---|---|---|---|
| Low | Medium | High | |
| Scenario 1: Preventive care, new injuries | |||
| Within SCI homecare catchment area | |||
| Net savings: Usual-telehealth option 1b | $214,560 to $262,240 | $334,656 to $409,024 | $614,016 to $750,464 |
| Outside SCI homecare catchment area | |||
| Net savings: Usual-telehealth option 1b
|
$-1,864,944 to $-2,279,376 | $-1,743,408 to $-2,130,832 | $-664,128 to $-811,712 |
| Net savings: Usual-telehealth option 2c
|
$89,136 to $108,944 | $169,344 to $206,976 | $1,313,712 to $1,605,648 |
|
| |||
| Scenario 2: Existing pressure ulcer | |||
| Outside SCI homecare catchment area |
|||
| Net savings: Usual-telehealth option 3 |
$1,550,160 to $1,894,640 | $1,704,960 to $2,083,840 | $1,870,560 to $2,286,240 |
|
| |||
| Scenario 3: Postsurgical care | |||
| Within SCI homecare catchment area | |||
| Net savings: Standard-telehealth option 1b
|
$-160,402 to $-196,046 | $-135,302 to $-165,370 | $-13,997 to $-17,107 |
| Net savings: Standard-telehealth option 3d
|
$87,480 to $106,920 | $111,456 to $136,224 | $183,773 to $224,611 |
| Outside SCI homecare catchment area | |||
| Net savings: Standard-telehealth option 1b
|
$-176,040 to $-215,160 | $-148,694 to $-181,738 |
$-25,574 to $-31,258 |
| Net savings: Standard-telehealth option 3d
|
$28,901 to $35,323 | $47,520 to $58,080 | $114,005 to $139,339 |
|
| |||
| Total net savings implications based on Telehealth 1 for scenario 1 within SCI CA Telehealth 1 for scenario 1 outside SCI CA Telehealth 3 for scenario 2 outside SCI CA Telehealth 1 for scenario 3 within SCI CA Telehealth 1 for scenario 3 outside SCI CA |
$-436,666 to $-533,702 | $12,211 to $14,925 | $1,780,877 to $2,176,627 |
|
| |||
| Total net savings implications based on Telehealth 1 for scenario 1 within SCI CA Telehealth 2 for scenario 1 outside SCI CA Telehealth 3 for scenario 2 outside SCI CA Telehealth 3 for scenario 3 within SCI CA Telehealth 3 for scenario 3 outside SCI CA |
$1,970,237 to $2,408,067 | $2,367,936 to $2,894,144 | $4,096,066 to $5,006,302 |
CA: Catchment area; SCI: spinal cord injury; VA: U.S. Department of Veterans Affairs.
aFigures are in 2007 dollars.
bTelehealth option 1 used an interactive videoconferencing machine that was installed in the patient's home. cTelehealth option 2 used the same machine plus station-to-station (hub and spoke) teleconferencing. dTelehealth option 3 used low-cost equipment such as digital cameras and e-mail.