Original Title: Análisis de impacto presupuestario de un procedimiento de telemedicina en programas de aseguramiento de la calidad de las espirometrías en pacientes con EPOC

Authors' objectives: Calculate the budgetary impact that the introduction of a telemedicine procedure in quality assurance programs for spirometry carried out in Health Centers can have on the general budget of the Department of Health and Consumption of the Basque Government between 2010 and 2014.

Authors' results and conclusions: The budgetary impact on the expenditure on FS caused by the implementation of the telemedicine procedure for the quality assurance of spirometry in Health Centers, replacing the usual procedure, will be equal to € 18,051 (year 2010), € 67,620 (year 2011) , € 117,121 (year 2012), € 159,330 (year 2013) and € 205,257 (year 2014). For the time horizon (2010-2014), the total budget impact will be equal to € 567,380. Taking into account the average proportion of good and bad quality FS carried out with both procedures, the budgetary impact caused by the incorporation of the tele-spirometry procedure on spending on good quality FS (A and B) will be € 32,655 (year 2010), € 136,667 (year 2011), € 271,920 (year 2012), € 408,963 (year 2013) and € 557,573 (year 2014), and on spending on poor quality PE (C, D and F) will be - € 14,604 (year 2010), -69,047 € (year 2011), -154,798 € (year 2012), -249,633 € (year 2013) and -352,316 € (year 2014). For the period 2010-2014, the total budgetary impact for the former will be € 1,407,778 and for the latter of -840,398 €. The sensitivity analysis indicates that if each poor quality FS carried out (C, D and F) were repeated once, the budgetary impact on EF spending caused by the integration of the new procedure will be € 4,009 (year 2010), € 1,145 (year 2011), -31,776 € (year 2012), -80,822 € (year 2013) and -133,674 (year 2014), with the total budgetary impact for the 2010-2014 horizon of -241,118 €. Conclusions: The implementation in the Basque Health System of a telemedicine procedure to assure the quality of spirometry in Health Centers as a substitute for the procedure for carrying them out, will result in higher healthcare costs and better use of the financial resources used in performing spirometry, by increasing the expenditure on good quality FS (A and B) and decreasing that corresponding to poor quality FS (C, D and F), which do not provide any health benefit as they are useless for the COPD diagnosis and monitoring. If the poor quality spirometry is repeated at least once, replacing the usual procedure for performing PE with the tele-spirometry procedure will result in lower healthcare costs, that is, it will save financial resources.

Authors' methods: The budget impact analysis was performed based on the multicenter, controlled and longitudinal study, carried out by the Pulmonary Function Laboratory of the Hospital Universitario de Cruces in 2010, to analyze the effectiveness of telemedicine in quality assurance programs of spirometry performed by health professionals in Health Centers. From the perspective of the funder of the Basque Health System and for a 5-year time horizon (2010-2014), a telemedicine intervention was analyzed to ensure the quality of spirometry in Health Centers (tele-spirometry) compared to the usual procedure of realization of the same. The population under study were people over 40 years of age and residents in the Autonomous Community of the Basque Country, who are estimated to perform forced spirometry (FS) for the diagnosis and follow-up of COPD in the period under study, based on the data prevalence and underdiagnosis for the same observed in the EPI-SCAM study. For the 275 Health Centers with possibilities of integrating the tele-spirometry procedure, an incorporation rate of 5.5% was estimated for 2010, 18% for 2011 and 25.5% for 2012, 2013 and 2014. The average proportion of FS with quality A and B was calculated for the procedures under study, based on the results on their quality obtained in the study mentioned above. The specific direct costs of both procedures were measured and calculated. In the case of the tele-spirometry procedure, the cost of the software (e-Spiro platform), the cost of training in the use of the platform, the cost of human resources (administrator, coordinator and technician) necessary for the management and platform management and FS testing. In the case of the usual procedure, only the cost of the FS test was taken into account. The cost of training in performing FS was not calculated since it is common to both procedures. Different univariate sensitivity analyzes were performed, represented by a “tornado diagram”, in order to check the effect of the variables that presented greater uncertainty on the budget impact analysis.

Project Status: Completed

Year Published: 2012

URL for published report: https://www.euskadi.eus/contenidos/informacion/2012_osteba_publicacion/es_def/adjuntos/eku_12_02_espir_infor.pdf

English language abstract: There is no English language summary available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>