Abstract:
This paper uses a Data Envelopment Analysis (DEA) approach to explore the productivity impact of a telemedicine system for obstetrics and gynaecology (O-G) services in the Greek National Health Service (NHS). DEA is a technique that can provide valuable information to aid understanding of the complex relationship between investments in telemedicine and the efficient delivery of services. The study involved 32 (O-G) units located in both peripheral regions and the central area of Attica. Initially, DEA analysis was applied to the units without the use of telemedicine taking into consideration the number of beds, staffing numbers and total expenditure. The analysis indicated that overall improvements in efficiency of between 6-10% could be achieved. There was, however, a marked difference between the units in peripheral regions and Attica. To improve efficiency in the peripheral units would require a 26% reduction in staff and 12% reduction in beds, compared to less than 5% reduction for either beds or staff in Attica. Achievable cost savings were also much higher for peripheral regions compared to central areas. These figures reflect the current status of healthcare in Greece with female patients traveling from the peripheral regions to central areas to receive O-G services. As a consequence, there is overcapacity in peripheral regions. The effect of the introduction of telemedicine was next analysed. This demonstrated that its introduction produces a geographic redistribution of O-G cases with more cases being treated in the peripheral regions. Increased treatment in these regions is associated with increased expenditure for them of approximately 10-20%. This is, however, offset by a decrease of more than 50% in expenditure for the units in Attica due to less patients traveling from the peripheral regions to them for treatment. The introduction of telemedicine also produced significant improvements in efficiency permitting a reduction of approximately 15% in beds and 25% for staff in both peripheral regions and Attica. Improvements in efficiency were more profound in peripheral units with three units achieving a relative efficiency of 100% compared to zero before the introduction of telemedicine. Economically, the introduction of telemedicine was estimated to produce annual savings of 7.5 million Euros, and when combined with the recommendations obtained from DEA achieved total savings of over 13 million Euros or approximately 25% of current expenditure. In conclusion, the study indicates that the introduction of telemedicine would overcome the diagnostic-treatment gap that currently exists in non urban regions for the treatment of O-G cases and enable more patients to be treated in peripheral regions. Application of DEA methodology demonstrated that significant improvements in efficiency and utilisation of resources could also be achieved. © The Journal on Information Technology in Healthcare 2005.
Notes:
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