Cost analysis of Telemedicine use in Pediatric Nephrology -The LMIC perspective

Abstract Background The overall cost of managing chronic diseases is a significant barrier to accessing complete and timely healthcare, especially in rural and geographically isolated areas. This cost disparity becomes more pronounced in the case of children and more so in under-resourced regions of the world. In the era of COVID-19, as the need for physical distancing increased, there was a transition in approach to healthcare provision to Telemedicine consultations. The cost saving using teleconsultations is evaluated in this study in a pediatric nephrology clinic. Methodology This prospective cohort study was conducted at a tertiary care center in western Rajasthan from March 2021 to October 2022. All consecutive pediatric (29 days -18 years) patients attending telemedicine services for renal-related illness were enrolled. Basic demographic details were collected. The cost analysis was done after six months, in terms of perceived cost savings by a telemedicine consultation compared to an in-person visit during six months starting from enrolment. Results One hundred twelve patients were enrolled. Two hundred sixty-six teleconsultations attended. The 109 patients who could be followed up saved INR 4,57,900 during six months of follow-up. ( 3 lost to follow-up). The average cost saving was INR -1577/patient/visit. The patients saved 4.99 % of the family income [Median of 2.16 %( IQR: 0.66-5.5 %)]. The Highest expenditure per visit was incurred for food and transport. The median distance from the residence to the clinic was 122.5 km (IQR: 30-250). Over the six-month study period, our patients have saved a travel distance of 83274 km. (743 km per patient). C onclusion The use of telemedicine as a follow-up method helps save significant costs and distances travelled by patients.