A cost comparison of travel models and behavioural telemedicine for rural, Native American populations in New Mexico

Abstract

Besides the obvious benefits of increased access to healthcare and reduced health disparities, providing behavioural telehealth for rural Native American populations was estimated to be less costly than modelled equivalent care provided by travelling. Additionally, as administrative and coordination costs are a major component of telehealth costs, as programmes grow to serve more patients, the relative costs of these initial infrastructure as well as overall per-patient costs should decrease.

Managing CKD by Telemedicine: The Zuni Telenephrology Clinic

“…Thus, much of what transpires in an in-person interaction could be conducted through a video interaction. Telehealth has the potential to deliver more cost effective care 1 and to improve outcomes 2 . Regardless of cost-effectiveness 3 , in many settings the alternative to telemedicine may be no care.…”

Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics

“…To estimate the costs of providing cardiology care through VCC outreach, we estimated the direct travel costs and opportunity costs associated with travel for participating cardiologists. Opportunity costs associated with travel time and distance were estimated following the methods used in studies of specialist outreach clinics in the United Kingdom and psychiatrist outreach to Native American populations in New Mexico …”

“…Opportunity costs associated with travel time and distance were estimated following the methods used in studies of specialist outreach clinics in the United Kingdom 31,32 and psychiatrist outreach to Native American populations in New Mexico. 33 To estimate travel costs, driving times and distances for visiting cardiologists (ie, from primary practice locations to VCC locations) were also estimated using MPMileCharter and Microsoft MapPoint using the latitude/longitude information described above. For mileage costs, we used the 2014 Internal Revenue Service business mileage rate of $0.56/per mile.…”

Methodology for Evaluating Models of Telemental Health Delivery Against Population and Healthcare System Needs: Application to Telemental Healthcare for Rural Native Veterans

“…Although it generally performed well on ORH Promising Practices, the AITMH model's lack of uptake within VA indicates challenges with operational feasibility. In general, rural AI/AN models [36][37][38][39][40][79][80][81][82][83][84][85][86][87][88] performed well against the AITMH framework, particularly with respect to cultural facilitation, often including traditional healing or health professionals embedded in local communities. They also promote access to care, frequently establishing highquality service where none existed, and emphasizing partnerships across staff and institutions.…”

“…The Telebehavioral Health Center of Excellence 36 met the criterion for operational feasibility, demonstrated efficiency through reduced no-show rates, 79 and reported patient and physician cost savings. 80 The hybrid, tribally run Nuka System of Care, 38,[82][83][84][85][86][87][88] which cited several improvements relative to traditional government-run care, performed well against all frameworks.…”