Cost effectiveness, safety, and satisfaction with video telepsychiatry versus face-to-face care in ambulatory settings.

Videoconference telepsychiatry provides an alternative for the psychiatric treatment of mental health patients who reside in remote communities. The objective of this study was to compare institutional ambulatory and hospitalization costs, treatment adherence, patient and physician satisfaction, and treatment safety between mental healthcare via videoconferencing and care provided in person. Data collected for 1 year of telepsychiatry treatment was compared to that of the preceding year and a matched comparison group. Twenty-nine patients from Or Akiva and 20 patients from Reut Hostel in Hadera who met the inclusion criteria agreed to participate; 24 and 15 patients, respectively, completed the study. Forty-two matched patients, who continued face-to-face interviews, comprised the comparison group. Drop-out patients and those who did not consent to telepsychiatry treatment were not involved. During the year of telepsychiatry treatment, patients and physicians were satisfied and treatment was safe. However, 1 hour of telepsychiatry treatment was more expensive than face-to-face care, and a tendency of increased hospitalizations was noted. Adherence ratios before and during telepsychiatry treatment were similar, but were twice as high versus the comparison group. The limited sample size precludes the drawing of definite conclusions, and further studies involving a larger study population and longer duration of investigation is warranted.

[1]  J Simpson,et al.  Evaluation of a routine telepsychiatry service , 2001, Journal of telemedicine and telecare.

[2]  M. Dongier,et al.  Telepsychiatry: Psychiatric Consultation through two-way television. A controlled study. , 1986, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[3]  Barbara M. Rohland,et al.  Telepsychiatry in the Heartland: If We Build It, Will They Come? , 2001, Community Mental Health Journal.

[4]  P. Hauser,et al.  Treatment outcomes in depression: comparison of remote treatment through telepsychiatry to in-person treatment. , 2004, The American journal of psychiatry.

[5]  N. Doidge,et al.  Pilot study of televideo psychiatric assessments in an underserviced community. , 1999, The American journal of psychiatry.

[6]  J. Overall,et al.  The Brief Psychiatric Rating Scale , 1962 .

[7]  J. Ballenger,et al.  Procedural and methodological issues in telepsychiatry research and program development. , 2000, Psychiatric services.

[8]  R. Roine,et al.  Assessing telemedicine: a systematic review of the literature. , 2001, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[9]  F. Mair,et al.  Resisting and promoting new technologies in clinical practice: the case of telepsychiatry. , 2001, Social science & medicine.

[10]  S. Kavanagh,et al.  The fall and rise of the South Australian telepsychiatry network , 2001, Journal of telemedicine and telecare.

[11]  B. Frueh,et al.  Telepsychiatry for post-traumatic stress disorder , 2000, Journal of telemedicine and telecare.

[12]  J Simpson,et al.  Telepsychiatry as a routine service - the perspective of the patient , 2001, Journal of telemedicine and telecare.

[13]  A. Yoshino,et al.  Telepsychiatry: assessment of televideo psychiatric interview reliability with present‐ and next‐generation internet infrastructures , 2001, Acta psychiatrica Scandinavica.

[14]  I. Aas,et al.  Telemedical work and cooperation , 2001, Journal of telemedicine and telecare.

[15]  C. May,et al.  Limitations of patient satisfaction studies in telehealthcare: a systematic review of the literature. , 2001, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[16]  J O'Laughlen,et al.  Pilot studies of telemedicine for patients with obsessive-compulsive disorder. , 1995, The American journal of psychiatry.