A cost minimisation analysis in teledermatology: model-based approach
Open accessAbstract
BACKGROUND: Although store-and-forward teledermatology is increasingly becoming popular, evidence on its effects on efficiency and costs is lacking. The aim of this study, performed in addition to a clustered randomised trial, was to investigate to what extent and under which conditions store-and-forward teledermatology can reduce costs from a societal perspective. METHODS: A cost minimisation study design (a model based approach) was applied to compare teledermatology and conventional process costs per dermatology patient care episode. Regarding the societal perspective, total mean costs of investment, general practitioner, dermatologists, out-of-pocket expenses and employer costs were calculated. Uncertainty analysis was performed using Monte Carlo simulation with 31 distributions in the used cost model. Scenario analysis was performed using one-way and two-way sensitivity analyses with the following variables: the patient travel distance to physician and dermatologist, the duration of teleconsultation activities, and the proportion of preventable consultations. RESULTS: Total mean costs of teledermatology process were €387 (95%CI, 281 to 502.5), while the total mean costs of conventional process costs were €354.0 (95%CI, 228.0 to 484.0). The total mean difference between the processes was €32.5 (95%CI, -29.0 to 74.7). Savings by teledermatology can be achieved if the distance to a dermatologist is larger (> = 75 km) or when more consultations (> = 37%) can be prevented due to teledermatology. CONCLUSIONS: Teledermatology, when applied to all dermatology referrals, has a probability of 0.11 of being cost saving to society.In order to achieve cost savings by teledermatology, teledermatology should be applied in only those cases with a reasonable probability that a live consultation can be prevented. TRIAL REGISTRATION: This study is performed partially based on PERFECT D Trial (Current Controlled Trials No. ISRCTN57478950).
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To achieve economic validity of tele-dermatology, the system should only be used for cases with a high probability of preventing a live consultation.
“Eminovic et al. (2010) concluded that in order to achieve the economic validity of tele-dermatology, the system should only be used for cases with a high probability of preventing a live consultation.”
From Patient and practitioner satisfaction with tele-dermatology including Australia’s indigenous population: A systematic review of the literature (2016) · cites this paper as Eminovic et al., 2010
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Telemedicine in the Care of Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis
Lam, B. J. W., Loh, M. C. S., & Yew, Y. W. (2025) · Dermatitis · doi:10.1089/derm.2024.0173 · Cited by 1 · see citing works
Investigating tools to assist dairy farmers in identifying the causes of lameness in dairy cows
Chaplin, K. (2018) · The University of Queensland · doi:10.14264/uql.2018.428 · Cited by 1 · see citing works
Hautenauve, M. (2014) · OpenGrey (Institut de l'Information Scientifique et Technique)
E-learning and teledermatology: Are web-based images good enough for learning?
Afroj, S. (2014) · NORA - Norwegian Open Research Archives
Steiner, M. F. C. (2015) · Springer eBooks · doi:10.1007/978-3-319-26594-0_117-1
The application of operational research techniques to service improvement - teledermatology
England, T., Lowe, S., Davies, C. R., Wellington, M., & Brain, H. (2014) · ORCA Online Research @Cardiff (Cardiff University)
Telemedicine and Skin Cancer: Teledermatology and Teledermoscopy
van der Heijden, J. P., & Witkamp, L. (2013) · Springer eBooks · doi:10.1007/978-1-4614-7357-2_34
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Teledermatology: Economics and Cost-Effectiveness
Zakaria, A., & Amerson, E. H. (2023) · Updates in clinical dermatology · doi:10.1007/978-3-031-27276-9_6
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The Economic Impact of COVID-19 on Dermatology
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La téléexpertise en allergologie
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Impacto del programa piloto de teledermatología en el Hospital General Docente Calderón del Ecuador
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429 Assessing Cost-Effectiveness of Teledermatology for Skin Cancer Diagnosis: A Systematic Review
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Socioeconomic Evaluation of Pediatric Teledermatology in a Tertiary Hospital
Palazón‐Cabanes, J. C., Juan‐Carpena, G., Cabanes, B. P., de Gracia, L. B., Martínez-Miravete, M. T., & Betlloch, I. (2026) · Telemedicine Journal and e-Health · doi:10.1177/15305627261432980
- Authors
- Eminović, N., Dijkgraaf, M. G., Berghout, R. M., Prins, A. H., Bindels, P. J., & de Keizer, N. F.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- University Medical Center Utrecht (NL)
- Corresponding author
- Eminović, Nina
- Venue
- BMC Health Services Research
- Published
- 2010-08-25
- Volume
- 10
- Issue
- 1
- Pages
- 251-251
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC2940879
- OpenAlex
- W2133591535
- Cited by
- 86
- References
- 17
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 6 · 2017: 7 · 2016: 9 · 2015: 8 · 2014: 11 · 2013: 4 · 2012: 3
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Keywords
- teledermatology, store-and-forward telemedicine, cost minimization, dermatological care, social costs, dermatology referral, employer costs, out-of-pocket costs
- MeSH terms
- Cost-Benefit Analysis, Dermatology, Female, Humans, Male, Netherlands, Cluster Analysis, Randomized Controlled Trials as Topic, Cost Savings, Telemedicine, Models, Economic, Remote Consultation
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