Economic impact analysis of a tele-medicine program to improve the quality of apirometry in primary care

Introduction: The tele-spirometry (TS) procedure consists in a computer application ( espiro.osasunet ) which allows the control and improvement of the quality of the spirometry (S) carried out in primary care centers (PCC), leading a continuous training of professionals that perform the technique. Aim: To calculate the economic impact of a procedure of TS in the Basque Health Service. Methods: The study was based on the impact in the funder of the Public Health System and a time horizon of 5years: 2010-2014.We compared the TS with the usual procedure and calculated the direct costs of the test, the computer platform, training and staff for their handling. The population was calculated using the prevalence of COPD in Spain (Soriano ERJ 2009). Effectiveness was measured as the average of S with quality A+B (ATS). Results: The COPD population who will perform a S goes from 32.850 to 35.207 (2010-2014). At present (2011) 53 PCC have been involved and 1500 S have been done. At the end of 2014, 275 will be included and, with inicial data (Marina 2011 ERS Congress) 35000 S will be done yearly. The cost of one S for the procedure of TS, in 2010, was 48,17€ with an effectiveness of 83%; while for the usual procedure was 37,95€ and 57%. The budget impact analysis, at the end of the year 2014, reflected a decrease of 132.438€, with the assumption that the S of poor quality should be repeated. Conclusions: The TS procedure involves an increase in the initial budget but produces a saving of the 6.3% (€132.438) in the medium term. For subsequent studies we will have to know the economic impact that this improvement in the quality of the S may have on the diagnosis and prognosis of COPD patients.