This study evaluated patients' cost savings in a telehealth project at the University of Arkansas for Medical Sciences' (UAMS) during 1998-2002. Differences in patients' cost savings from telemedicine were assessed by gender, age, ethnicity, education, occupation, annual household income, health insurance status, and household and community size. Variables examined for patients' cost savings included travel distance for medical care, missed days at work, and family expenses. The study population consisted of self-selected telemedicine patients in rural Arkansas (N = 410 consults). Results suggest that without telemedicine, 94% of patients would travel greater than 70 miles for medical care; 84% would miss one day of work; and 74% would spend $75-$150 for additional family expenses. With telemedicine, 92% of patients saved $32 in fuel costs; 84% saved $100 in wages; and 74% saved $75-$150 in family expenses. Patients living alone (p < 0.001) and in smaller rural communities (p = 0.002) were significantly more likely to miss one day of work without telemedicine than patients with larger households and those residing in larger rural communities. Females (p = 0.040) and patients with a annual household income over $25,000 (p = 0.005) were significantly more likely to have family expenses over $150 without telemedicine than males and patients with a household income of $25,000 or less.
Socioeconomic and demographic factors can affect the impact of telehealth education programs that use interactive compressed video technology. This study assessed program satisfaction among participants in the University of Arkansas for Medical Sciences' School Telehealth Education Program delivered by interactive compressed video. Variables in the one-group posttest study were age, gender, ethnicity, education, community size, and program topics for years 1997-1999. The convenience sample included 3,319 participants in junior high and high schools. The School Telehealth Education Program provided information about health risks, disease prevention, health promotion, personal growth, and health sciences. Adolescents reported medium to high levels of satisfaction regarding program interest and quality. Significantly higher satisfaction was expressed for programs on muscular dystrophy, anatomy of the heart, and tobacco addiction (p < 0.001 to p = 0.003). Females, African Americans, and junior high school students reported significantly greater satisfaction (p < 0.001 to p = 0.005). High school students reported significantly greater satisfaction than junior high school students regarding the interactive video equipment (p = 0.011). White females (p = 0.025) and African American males (p = 0.004) in smaller, rural communities reported higher satisfaction than White males. The School Telehealth Education Program, delivered by interactive compressed video, promoted program satisfaction among rural and minority populations and among junior high and high school students. Effective program methods included an emphasis on participants' learning needs, increasing access in rural areas among ethnic groups, speaker communication, and clarity of the program presentation.
We conducted a post-consultation survey during 1998-2002 (n = 412 consultations) in the Rural Hospital Telehealth Project run by the University of Arkansas for Medical Sciences. Changes in the patient's diagnosis and treatment plan as a result of the telemedicine session were assessed. There were 47 consultants, who conducted 2-82 consultations each. The teleconsultants established a diagnosis in 74 consultations. This was 26% of the 286 respondents. Of the 63 respondents for cases where there was a prior diagnosis and a change was applicable, 17 consultants (27%) reported that there was a change in the patient's diagnosis. The consultants established a patient treatment plan in 139 consultations. This was 52% of the 268 respondents. Of the 123 respondents for cases where there was a prior treatment plan and a change was applicable, 82 (67%) consultants reported a change in the treatment plan. The changes in diagnosis and management imply benefits for the rural population in Arkansas as a result of the use of telemedicine.
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