A Modeled Analysis of Telehealth Methods for Treating Pressure Ulcers after Spinal Cord Injury

Table 6

System-level cost implications of standard care versus telehealth.

	Cost estimates^a
	Low	Medium	High
Scenario 1: Preventive care, new injuries
Within SCI homecare catchment area
Net savings: Usual-telehealth option 1^b	$214,560 to $262,240	$334,656 to $409,024	$614,016 to $750,464
Outside SCI homecare catchment area
Net savings: Usual-telehealth option 1^b	$-1,864,944 to $-2,279,376	$-1,743,408 to $-2,130,832	$-664,128 to $-811,712
Net savings: Usual-telehealth option 2^c	$89,136 to $108,944	$169,344 to $206,976	$1,313,712 to; $1,605,648
Scenario 2: Existing pressure ulcer
Outside SCI homecare catchment area
Net savings: Usual-telehealth option 3	$1,550,160 to $1,894,640	$1,704,960 to $2,083,840	$1,870,560 to $2,286,240
Scenario 3: Postsurgical care
Within SCI homecare catchment area
Net savings: Standard-telehealth option 1^b	$-160,402 to $-196,046	$-135,302 to $-165,370	$-13,997 to $-17,107
Net savings: Standard-telehealth option 3^d	$87,480 to $106,920	$111,456 to $136,224	$183,773 to $224,611
Outside SCI homecare catchment area
Net savings: Standard-telehealth option 1^b	$-176,040 to $-215,160	$-148,694 to; $-181,738	$-25,574 to; $-31,258
Net savings: Standard-telehealth option 3^d	$28,901 to $35,323	$47,520 to $58,080	$114,005 to $139,339
Total net savings implications based on; Telehealth 1 for scenario 1 within SCI CA; Telehealth 1 for scenario 1 outside SCI CA; Telehealth 3 for scenario 2 outside SCI CA; Telehealth 1 for scenario 3 within SCI CA; Telehealth 1 for scenario 3 outside SCI CA	$-436,666 to $-533,702	$12,211 to $14,925	$1,780,877 to $2,176,627
Total net savings implications based on; Telehealth 1 for scenario 1 within SCI CA; Telehealth 2 for scenario 1 outside SCI CA; Telehealth 3 for scenario 2 outside SCI CA; Telehealth 3 for scenario 3 within SCI CA; Telehealth 3 for scenario 3 outside SCI CA	$1,970,237 to $2,408,067	$2,367,936 to $2,894,144	$4,096,066 to $5,006,302

CA: Catchment area; SCI: spinal cord injury; VA: U.S. Department of Veterans Affairs.
^aFigures are in 2007 dollars.
^bTelehealth option 1 used an interactive videoconferencing machine that was installed in the patient’s home. ^cTelehealth option 2 used the same machine plus station-to-station (hub and spoke) teleconferencing. ^dTelehealth option 3 used low-cost equipment such as digital cameras and e-mail.