Medical University of South Carolina Lake Elmo, Minnesota
Educational Objective: At the conclusion of this presentation, the participants should be able to understand how telemedicine associated cost savings have been characterized across pediatric surgical specialties.
Objectives: Telemedicine is a rapidly expanding care modality in the United States. Pediatric surgical patients often require complex care which can incur significant expenses, some of which may be alleviated by telemedicine. We reviewed the literature describing telemedicine's impact on the cost of healthcare across pediatric surgical specialties. Study Design: Systematic review using the following databases: PubMed (Medline), Scopus (Elsevier), and CINAHL (EBSCOHost), searched from inception to August 20, 2021.
Methods: Studies were included per the following criteria: 1) conducted in the US; 2) described a telemedicine intervention in the context of pediatric surgical care; and 3) provided a metric of telemedicine cost compared to an in-person visit.
Results: Nine studies satisfied inclusion criteria, encompassing the following pediatric specialties: general surgery (2), orthopedic surgery (2), urology (2), neurosurgery (1), ophthalmology (1), and otolaryngology (1). The average age was 6.4 ┬▒ 2.1 years. There were 868 documented virtual encounters which spanned clinic (44%), postoperative (33%), preoperative (11%) and diagnostic/screening (11%) visits. Of the studies which calculated cost, the mean savings was $150.01 ┬▒ $114.42 per telemedicine visit. Over half (55.6%) of studies included families who spared more than 1.5 hours or 100 miles of travel by attending virtual visits. One study documented more than 50% of telemedicine appointments were billed as level 4 visits.
Conclusions: This systematic review suggests telemedicine provides cost incentives to pediatric surgical care in certain scenarios. Future work should be directed towards standardizing the metrics by which cost savings are analyzed and detailing which types of visits are most appropriately facilitated by telemedicine.