Cost-effectiveness of digital care and face-to-face care in the first-level of care

Authors

  • César Silva-Luna <p>Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 49, Servicio de Medicina Familiar. Celaya, Guanajuato, M&eacute;xico.</p> http://orcid.org/0000-0002-9636-2916
  • Enrique Villarreal-Ríos <p>Instituto Mexicano del Seguro Social, &Oacute;rgano de Operaci&oacute;n Administrativa Desconcentrada Quer&eacute;taro, Unidad de Investigaci&oacute;n Epidemiol&oacute;gica y en Servicios de Salud. Quer&eacute;taro, Quer&eacute;taro, M&eacute;xico.</p> http://orcid.org/0000-0002-5455-2383
  • Liliana Galicia-Rodríguez <p>Instituto Mexicano del Seguro Social, &Oacute;rgano de Operaci&oacute;n Administrativa Desconcentrada Quer&eacute;taro, Unidad de Investigaci&oacute;n Epidemiol&oacute;gica y en Servicios de Salud. Quer&eacute;taro, Quer&eacute;taro, M&eacute;xico.</p> http://orcid.org/0000-0001-5140-8434
  • Laura Estefanía Rosas-Marín <p>Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 49, Coordinaci&oacute;n Cl&iacute;nica de Educaci&oacute;n e Investigaci&oacute;n. Celaya, Guanajuato, M&eacute;xico.</p> http://orcid.org/0000-0002-3291-2288
  • Mireya Franco-Saldaña <p>&nbsp;Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 49, Direcci&oacute;n. Celaya, Guanajuato, M&eacute;xico.</p> http://orcid.org/0000-0002-0777-6886
  • Mariana del Rayo Guerrero-Mancera <p>Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 49, Coordinaci&oacute;n de Residencia en Medicina Familiar. Celaya, Guanajuato, M&eacute;xico.</p> http://orcid.org/0000-0003-0649-4956
  • Juana Liliana Sandoval-Barajas <p>Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 49, Coordinaci&oacute;n Cl&iacute;nica de Consulta de Medicina Familiar. Celaya, Guanajuato, M&eacute;xico.</p> http://orcid.org/0009-0007-9425-6398
  • Arturo Silva-Núñez <p>Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 49, Consulta de Medicina Familiar. Celaya, Guanajuato, M&eacute;xico.</p> http://orcid.org/0009-0002-6978-7641

DOI:

https://doi.org/10.5281/

Keywords:

Health Services, Remote Consultation, Cost-Effectiveness Evaluation

Abstract

Background: The medical care paradigm is face-to-face; however, technological development has led to the digital modality.

Objective: To determine cost-effectiveness of digital care and face-to-face care at the first level of care.

Material and methods: Cost-effectiveness study. 2 groups were integrated: the digital service and the face-to-face service. The sample size was calculated with the percentage formula for 2 groups, and the result was 217 per group. The effectiveness was evaluated in 3 dimensions: the satisfaction of the patient, of the doctor and of the medical assistant. In all 3 cases the Visual analogue scale was used. The cost corresponded to the fixed unit cost estimated with the technique of times and movements adjusted for the duration of care. The statistical analysis included averages, percentages and cost-effectiveness ratio.

Results: The cost of digital attention is $343.83 and face-to-face attention is $171.91 (all estimated in Mexican pesos). From the patient's perspective, the effectiveness in digital care is $9.47 and in face-to-face is $9.25. The cost to reach effectiveness of 10 in face-to-face care is $185.85 and in digital care $363.20. From the physician's perspective, the cost to achieve effectiveness of 10 is $419.13 in digital care and $184.52 in face-to-face care. From the perspective of the medical assistant, to achieve effectiveness of 10, the cost in digital care is $468.43 and in face-to-face $179.83.

Conclusions: Currently, the best cost-effectiveness ratio corresponds to face-to-face care; however, digital care is an option that will have to evolve.

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Published

2023-12-21

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Section

Original Articles