DESCRIPTIVE COST ANALYSIS OF TELECONSULTATION IN UMMC DIABETES CLINIC

ABSTRACT

Introduction Teleconsultation has become an increasingly important service in managing T2DM especially with the ongoing COVID-19 pandemic and is assumed to be less costly to patients compared to physical visits. This study aimed to compare patients' cost for a teleconsultation session vs physical clinic visit. Methodology This was a cross-sectional study from June 2020 to December 2021 in UMMC which included patients who had successfully participated in teleconsultation sessions. Patient interviews were conducted to collect demographics, detailed cost items (direct/ indirect cost) and a self-administered Patient Satisfaction Questionnaire Short Form (PSQ-18). HbA1c and average self-monitoring blood glucose (SMBG) records at baseline and 3-months after teleconsultation were obtained from electronic medical records (EMR). Results A total of 36 patients were recruited. The median cost of attending a physical visit was significantly higher compared to teleconsultation (RM 123.41 [54.29, 219.51] vs RM 41.41 [30.55, 49.66];p<0.001) with a median cost difference of RM 81.24 [20.20,171.69]. Indirect costs (income loss from absence) made up the majority of the cost saving with teleconsultation (teleconsultation RM 10.71 [0.00,18.45], physical visit RM95.24 [0.00,182.74];p<0.001). There was a reduction in HbA1c (9.45% [7.98, 11.38] to 8.25% [7.42, 9.49];p<0.001) and average fasting SMBG (8.11 mmol/L [6.75, 9.70] to 7.20 mmol/L [6.22, 8.71];p=0.03) after 3 months of teleconsultation. Patients reported high satisfaction levels with teleconsultation, with an overall PSQ-18 score of 78%. Conclusion Teleconsultation service in UMMC Diabetes outpatient clinic was cost saving to patients compared to physical visits without compromising blood glucose control. Teleconsultation may be a viable option of healthcare provision for many patients and may be considered as part of routine care.