Evidence map›Paper›PMID 38145481›Full record

Trial reportJournal of medical Internet research2023

Digitization of Follow-Up Care in Orthopedic and Trauma Surgery With Video Consultations: Health Economic Evaluation Study From a Health Provider's Perspective.

Jennifer Muschol, Martin Heinrich, Christian Heiss, Alher Mauricio Hernandez, Gero Knapp, Holger Repp, Henning Schneider, Ulrich Thormann, Johanna Uhlar, Kai Unzeitig and 1 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of medical Internet research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Environmental impact of patient travel for cataract surgery.International journal of ophthalmology · 2025
    Article
  6. Review
  7. Article
  8. [Orthopedics and trauma surgery in the digital age].Orthopadie (Heidelberg, Germany) · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Jennifer MuscholDepartment of Health Economics, Justus Liebig University, Giessen, Germany.ORCID 0000-0002-1563-0078
Martin HeinrichDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, Giessen, Germany.ORCID 0000-0003-0858-1551
Christian HeissDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, Giessen, Germany.ORCID 0000-0002-9593-162X
Alher Mauricio HernandezBioinstrumentation and Clinical Engineering Research Group, Bioengineering Department, Engineering Faculty, Universidad de Antioquia, Medellín, Colombia.ORCID 0000-0003-1132-5794
Gero KnappDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, Giessen, Germany.ORCID 0000-0001-9864-547X
Holger ReppDepartment of Health Economics, Justus Liebig University, Giessen, Germany.ORCID 0000-0002-6979-6807
Henning SchneiderInstitute of Medical Informatics, Justus Liebig University, Giessen, Germany.ORCID 0000-0002-9958-4434
Ulrich ThormannDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, Giessen, Germany.ORCID 0000-0002-8935-4731
Johanna UhlarInstitute of Medical Informatics, Justus Liebig University, Giessen, Germany.ORCID 0000-0001-7270-8946
Kai UnzeitigDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, Giessen, Germany.ORCID 0000-0002-6391-0031
Christian GisselDepartment of Health Economics, Justus Liebig University, Giessen, Germany.ORCID 0000-0001-6656-0877
Justus-Liebig-Universität Gießen · DEUniversitätsklinikum Gießen und Marburg · DEUniversidad de Antioquia · CO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecommendations for health care digitization as issued with the Riyadh Declaration led to an uptake in telemedicine to cope with the COVID-19 pandemic. Evaluations based on clinical data are needed to support stakeholders' decision-making on the long-term implementation of digital health.

objectiveThis health economic evaluation aims to provide the first German analysis of the suitability of video consultations in the follow-up care of patients in orthopedic and trauma surgery, investigate the financial impact on hospital operations and personnel costs, and provide a basis for decisions on digitizing outpatient care.

methodsWe conducted a randomized controlled trial that evaluated video consultations versus face-to-face consultations in the follow-up care of patients in orthopedic and trauma surgery at a German university hospital. We recruited 60 patients who had previously been treated conservatively or surgically for various knee or shoulder injuries. A digital health app and a browser-based software were used to conduct video consultations. The suitability of telemedicine was assessed using the Telemedicine Satisfaction Questionnaire and the EQ-5D-5L questionnaire. Economic analyses included average time spent by physician per consultation, associated personnel costs and capacities for additional treatable patients, and the break-even point for video consultation software fees.

resultsAfter 4 withdrawals in each arm, data from a total of 52 patients (telemedicine group: n=26; control group: n=26) were used for our analyses. In the telemedicine group, 77% (20/26) of all patients agreed that telemedicine provided for their health care needs, and 69% (18/26) found telemedicine an acceptable way to receive health care services. In addition, no significant difference was found in the change of patient utility between groups after 3 months (mean 0.02, SD 0.06 vs mean 0.07, SD 0.17; P=.35). Treatment duration was significantly shorter in the intervention group (mean 8.23, SD 4.45 minutes vs mean 10.92, SD 5.58 minutes; P=.02). The use of telemedicine saved 25% (€2.14 [US $2.35]/€8.67 [US $9.53]) in personnel costs and increased the number of treatable patients by 172 annually, assuming 2 hours of video consultations per week. Sensitivity analysis for scaling up video consultations to 10% of the hospital's outpatient cases resulted in personnel cost savings of €73,056 (US $ 80,275.39) for a senior physician. A total of 23 video consultations per month were required to recoup the software fees of telemedicine through reduced personnel costs (break-even point ranging from 12-38 in the sensitivity analysis).

conclusionsOur study supports stakeholders' decision-making on the long-term implementation of digital health by demonstrating that video consultations in the follow-up care of patients in orthopedic and trauma surgery result in cost savings and productivity gains for clinics with no negative impact on patient utility.

trial registrationGerman Clinical Trials Register DRKS00023445; https://drks.de/search/en/trial/DRKS00023445.

Indexed as

AftercareTelemedicineAcute Care SurgeryCost-Benefit AnalysisHumansOrthopedicsPandemicsVideoconferencingWounds and Injuriesdigital healtheconomic evaluationhealth economicsorthopedicpersonnel costsproductivity gainstelemedicinetrauma surgeryutilityvideo consultations

Identifiers

PMID38145481
PMCPMC10775022
OpenAlexW4390192293

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.