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What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation
  1. Clare Liddy1,
  2. Paul Drosinis1,
  3. Catherine Deri Armstrong2,
  4. Fanny McKellips1,
  5. Amir Afkham3,
  6. Erin Keely4
  1. 1C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
  2. 2Department of Economics, University of Ottawa, Ottawa, Ontario, Canada
  3. 3The Champlain Local Health Integration Network, Ottawa, Ontario, Canada
  4. 4Division of Endocrinology and Metabolism, The Ottawa Hospital—Riverside Campus, Ottawa, Ontario, Canada
  1. Correspondence to Dr Clare Liddy; cliddy{at}bruyere.org

Abstract

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015.

Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period.

Setting Champlain health region in Eastern Ontario, Canada.

Population Primary care providers and specialists registered to use the eConsult service.

Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings.

Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult.

Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner.

  • eConsult
  • referral
  • access to care
  • wait times
  • cost

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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