Published online by Cambridge University Press: 29 October 2018
Chronic wounds are frequent, affect quality of life, and increase care costs. Telemedicine provides potential for effective wound care management, especially for the monitoring of complex wounds at home.
The objective of the present study was to determine the clinical effects and costs of telemedicine for the follow-up of complex chronic wounds from the perspective of the public health insurance. The study ran over a period of 9 months.
We conducted a prospective, pragmatic, open-label, observational study and carried out a cost-effectiveness analysis. A total of 116 patients with chronic wounds were assigned to their choice of two groups: telemedicine (N = 77) and traditional follow-up (control; N = 39). The primary outcome was the time to healing. Secondary outcomes included percentage of wounds reaching target objective, percentage of wounds healed completely, outpatient care costs, travel costs, and hospitalizations.
Time to healing was shorter in the telemedicine group than in the control group (137 versus 174 days; p < .05). The percentage of wounds completely healed was not statistically different between the telemedicine and control group (66 percent versus 61 percent; p > .05). Outpatient care and hospitalization costs were not significantly different. The main results in terms of economic savings were medical transport costs reimbursed by the French public health insurance, which were significantly lower in the telemedicine group. Telemedicine costs were found to be €4,583 less per patient compared with standard practice over 9 months.
This trial suggests that telemedicine saves travel costs and results in a shorter healing time than traditional follow-up.
We thank the funders of the study: the French digital health agency ASIP Santé; the Regional Health Agency (ARS) of Basse-Normandie; the ARS of Languedoc-Roussillon; and the healthcare cooperation consortium GCS e-health. We also thank the Regional Directorate of Health Insurance of Rouen, in particular Dr. Kuhn, and all health professionals and patients of TELAP network who participated in the trial. No conflicts of interest.