%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 25
%N 
%P e46714
%T Digitization of Follow-Up Care in Orthopedic and Trauma Surgery With Video Consultations: Health Economic Evaluation Study From a Health Provider’s Perspective
%A Muschol,Jennifer
%A Heinrich,Martin
%A Heiss,Christian
%A Hernandez,Alher Mauricio
%A Knapp,Gero
%A Repp,Holger
%A Schneider,Henning
%A Thormann,Ulrich
%A Uhlar,Johanna
%A Unzeitig,Kai
%A Gissel,Christian
%+ Department of Health Economics, Justus Liebig University, Klinikstrasse 29, Giessen, 35392, Germany, 49 641  99 48550, cg@phec.de
%K digital health
%K economic evaluation
%K health economics
%K orthopedic
%K personnel costs
%K productivity gains
%K telemedicine
%K trauma surgery
%K utility
%K video consultations
%D 2023
%7 25.12.2023
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: Recommendations for health care digitization as issued with the Riyadh Declaration led to an uptake in telemedicine to cope with the COVID-19 pandemic. Evaluations based on clinical data are needed to support stakeholders’ decision-making on the long-term implementation of digital health. Objective: This health economic evaluation aims to provide the first German analysis of the suitability of video consultations in the follow-up care of patients in orthopedic and trauma surgery, investigate the financial impact on hospital operations and personnel costs, and provide a basis for decisions on digitizing outpatient care. Methods: We conducted a randomized controlled trial that evaluated video consultations versus face-to-face consultations in the follow-up care of patients in orthopedic and trauma surgery at a German university hospital. We recruited 60 patients who had previously been treated conservatively or surgically for various knee or shoulder injuries. A digital health app and a browser-based software were used to conduct video consultations. The suitability of telemedicine was assessed using the Telemedicine Satisfaction Questionnaire and the EQ-5D-5L questionnaire. Economic analyses included average time spent by physician per consultation, associated personnel costs and capacities for additional treatable patients, and the break-even point for video consultation software fees. Results: After 4 withdrawals in each arm, data from a total of 52 patients (telemedicine group: n=26; control group: n=26) were used for our analyses. In the telemedicine group, 77% (20/26) of all patients agreed that telemedicine provided for their health care needs, and 69% (18/26) found telemedicine an acceptable way to receive health care services. In addition, no significant difference was found in the change of patient utility between groups after 3 months (mean 0.02, SD 0.06 vs mean 0.07, SD 0.17; P=.35). Treatment duration was significantly shorter in the intervention group (mean 8.23, SD 4.45 minutes vs mean 10.92, SD 5.58 minutes; P=.02). The use of telemedicine saved 25% (€2.14 [US $2.35]/€8.67 [US $9.53]) in personnel costs and increased the number of treatable patients by 172 annually, assuming 2 hours of video consultations per week. Sensitivity analysis for scaling up video consultations to 10% of the hospital’s outpatient cases resulted in personnel cost savings of €73,056 (US $ 80,275.39) for a senior physician. A total of 23 video consultations per month were required to recoup the software fees of telemedicine through reduced personnel costs (break-even point ranging from 12-38 in the sensitivity analysis). Conclusions: Our study supports stakeholders’ decision-making on the long-term implementation of digital health by demonstrating that video consultations in the follow-up care of patients in orthopedic and trauma surgery result in cost savings and productivity gains for clinics with no negative impact on patient utility. Trial Registration: German Clinical Trials Register DRKS00023445; https://drks.de/search/en/trial/DRKS00023445 
%M 38145481
%R 10.2196/46714
%U https://www.jmir.org/2023/1/e46714
%U https://doi.org/10.2196/46714
%U http://www.ncbi.nlm.nih.gov/pubmed/38145481