BACKGROUND Store-and-forward (SAF) teledermatology (TD) has the potential to increase access to timely, high-quality care for underserved populations. However, the cost-effectiveness of TD for underserved populations is uncertain. OBJECTIVE This study evaluates the potential cost savings associated with an SAF TD program implemented for an underserved population in the city health clinics of urban Philadelphia. METHODS We performed a retrospective analysis of SAF TD consultations for 700 outpatients managed in 12 Philadelphia primary care clinics. Primary care providers were asked to specify a treatment plan, as well as the type of care for the patient, in the absence of the TD service. Analysis compared the cost of each patient case with use of the TD consult model versus with conventional care. RESULTS In all, 27% of in-person dermatology clinic visits (189 of 700) and 3.29% of emergency room visits (23 of 700) were avoided by using TD. Compared with conventional care, TD had a mean expected cost savings of $10.00 to $52.65 per TD consult. In sensitivity analyses, these estimated savings remained positive across a range of parameters. LIMITATIONS The cost analysis relies on several assumptions regarding the cost of care, and indirect costs were not included. CONCLUSION TD can be a cost-saving model while increasing access to dermatologic care.

中文翻译：

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费城的存储转发远距离皮肤病学咨询系统的成本分析。

背景技术存储转发（SAF）远程皮肤病学（TD）具有为服务不足的人群增加及时，高质量护理的机会。但是，TD对于服务不足的人群的成本效益尚不确定。目的本研究评估了在费城城市卫生诊所为服务不足的人群实施的SAF TD计划可能节省的成本。方法我们对费城12家初级保健诊所中700名门诊患者的SAF TD咨询进行了回顾性分析。在没有TD服务的情况下，要求初级保健提供者指定治疗计划以及患者的护理类型。分析比较了使用TD咨询模型与常规护理的每例患者的费用。结果总的来说，通过使用TD避免了27％的亲自皮肤科诊所就诊（700例中的189例）和3.29％的急诊室就诊（700例中的23例）。与传统护理相比，TD每位TD咨询平均可节省成本10.00至52.65美元。在敏感性分析中，这些估计的节省量在一系列参数中保持正值。局限性成本分析依赖于有关护理成本的几个假设，并且不包括间接成本。结论TD可以成为节省成本的模型，同时增加获得皮肤病护理的机会。局限性成本分析依赖于有关护理成本的几个假设，并且不包括间接成本。结论TD可以成为节省成本的模型，同时增加获得皮肤病护理的机会。局限性成本分析依赖于有关护理成本的几个假设，并且不包括间接成本。结论TD可以成为节省成本的模型，同时增加获得皮肤病护理的机会。