Browsing by Author "Rademaker, M"
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- ItemA cost-minimization analysis of the societal costs of realtime teledermatology compared with conventional care: results from a randomized controlled trial in New Zealand.(2001-08-16) Loane, M A; Oakley, A; Rademaker, M; Bradford, N; Fleischl, P; Kerr, P; Wootton, RA randomized controlled trial was carried out to measure the societal costs of realtime teledermatology compared with those of conventional hospital care in New Zealand Two rural health centres were linked to a specialist hospital via ISDN at 128 kbit s Over 10 months 203 patients were referred for a specialist dermatological consultation and 26 were followed up giving a total of 229 consultations Fifty four per cent were randomized to the teledermatology consultation and 46 to the conventional hospital consultation A cost minimization analysis was used to calculate the total costs of both types of dermatological consultation The total cost of the 123 teledermatology consultations was NZ 34 346 and the total cost of the 106 conventional hospital consultations was NZ 30 081 The average societal cost of the teledermatology consultation was therefore NZ 279 23 compared with NZ 283 79 for the conventional hospital consultation The marginal cost of seeing an additional patient was NZ 135 via teledermatology and NZ 284 via conventional hospital appointment From a societal viewpoint and assuming an equal outcome teledermatology was a more cost efficient use of resources than conventional hospital care
- ItemPatient cost-benefits of realtime teledermatology--a comparison of data from Northern Ireland and New Zealand.(2000-06-12) Oakley, A M; Kerr, P; Duffill, M; Rademaker, M; Fleischl, P; Bradford, N; Mills, CAs part of a randomized controlled trial of the costs and benefits of realtime teledermatology in comparison with conventional face to face appointments patients were asked to complete a questionnaire at the end of their consultation One hundred and nine patients took part in an initial teledermatology consultation and 94 in a face to face consultation The proportion of patients followed up by the dermatologist was almost the same after teledermatology 24 as after a hospital appointment 26 and for similar reasons Two hundred and three questionnaires were completed after the first visit and a further 20 after subsequent visits Patients seen by teledermatology at their own health centre travelled an average of 12 km whereas those who attended a conventional clinic travelled an average of 271 km The telemedicine group spent an average of 51 min attending the appointment compared with 4 3 h for those seen at the hospital The results of the present study as in a similar study conducted in Northern Ireland show that the economic benefits of teledermatology favour the patient rather than the health care system
- ItemTeledermatology in the Waikato region of New Zealand.(2001-12-18) Oakley, A; Rademaker, M; Duffill, MTeledermatology consultations over a video link began at Health Waikato in 1995 Clinical trials involving about 500 patients have demonstrated the diagnostic accuracy and economic gains of these teleconsultations and patient satisfaction with them Yet six years on out of date equipment remains under used There has been no expansion of the network and no additional clinical teleconsultation services Possible reasons include the excessive capital cost of videoconferencing equipment clinician overwork inconvenience lack of reimbursement administrative and governmental inertia and little demand from patients and their doctors To widen our referral base without the inconvenience of videoconferencing we decided to offer a secure browser based dermatology tele advice service to referring general practitioners who owned digital cameras With the increase in online health information and electronic communication we assumed it would be popular But despite up to six month waits for patients to be seen in the dermatology outpatient clinic few patients have been referred to the service Explanations have included time constraints unavailability of a camera no Internet access at the time of consultation and lack of reimbursement Can we look forward to a future in which all doctors have high speed access to the Internet at their desktop through their practice management systems Who will pay Will they continue to prefer conventional referral