Either Abstract

(Adults - Diabetes mellitus), #220531783834

DESCRIPTIVE COST ANALYSIS OF TELECONSULTATION IN UMMC DIABETES CLINIC

Nazri Ab.Kahar, Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia; Lim Quan Hziung, Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia; Luqman Ibrahim, Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia; Jeyakantha Ratnasingam, Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia; Shireene Vethakkan, Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia; Lee-Ling Lim, Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia; Sharmila Paramasivam, Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia

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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.

Methods

This was a cross-sectional study from June 2020 till December 2021 in UMMC involving 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 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 (RM123.41 [54.29, 219.51] vs RM41.41 [30.55, 49.66]; p<0.001) with a median cost difference of RM81.24 [20.20,171.69]. Indirect costs (income loss from absence) made up the majority of the cost saving (teleconsultation RM10.71 [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 7.20mmol/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. This may provide another option of healthcare provision to many patients and may be considered as part of routine care.

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