Economic evaluation of telemedicine for a remotely located population: the case of two Greek islands.

A 12-month trial with telemedicine was conducted at two remote health centres located on Greek Islands, namely Lemnos and Skyros, where combat units of the Greek Airforce are situated. The units' medical services are supported by the 251st Central Hospital of the Greek Airforce in Athens, via a PC-based ISDN videoconferencing link, connected at 384 Kbps. Thirty-eight patients were recruited for the trial. A cost minimisation analysis was undertaken, for comparing the costs of telemedicine to those of hospital referrals, where patients from remote areas travelled to the hospital for consultation. The cost, per patient, for remote consultation was calculated to be 203.5 euro compared to 270 euro for referrals. These results proved to be relatively robust after being tested with a sensitivity analysis. The benefits and cost savings would be greater in the case of islands or other such remote communities, where patients have to travel long distances either for hospitalisation or for specialist consultations. However, it should be noted that the cost of telemedicine depends on the number of patients served in the isolated area.