OBJECTIVES : TeleOftalmo is a Brazilian project that provides telemedicine services in ophthalmology to improve population's access to diagnosis. Our study aimed to describe the impact on health and economic outcomes of TeleOftalmo compared with traditional medical visits at the Brazilian public health system

METHODS : This prospective study analyzed patients assisted at the TeleOftalmo program and conventional ophthalmology in-person visits for three months. Utility data were collected before (t0) and at the 3-month (t3) clinical visit, using the Visual Function Questionnaire-Utility Index (VFQ-UI) instrument. Data from t(0) was collected between December 2019 and January 2020. Costs of health services were analyzed by the Time-driven Activity-based Costing method (TDABC). Results were converted to international dollars by the Purchasing Power Parity rate in 2019.

RESULTS : 536 patients were included in the study, 252 from the in-person visits group, and 284 from TeleOftalmo. The mean utility score (SD) at t(0) for TeleOftalmo group was 0.808 (SD 0.14) and for in-person ophthalmologic visits it was 0.789 (0.15). At t(3) utility score was 0.812 (0.15) and 0.795 (0.16), respectively. The adjusted analysis for VFR-qualify of life did not demonstrate a significant difference between groups in repeated measures (unadjusted p=0.352 and adjusted p=0.710). The unit cost per telediagnosis at TeleOftalmo was Int$ 96.9 (IQR Int$ 82.5; Int$ 199.4), while an in-person visit cost Int$ 77.2 (IQR Int$ 74.9; Int$ 80.0). Considering service's full capacity, while redesigning the process, TeleOftalmo's unit cost could decrease to Int$ 53.3. This represents a cost reduction of 31%, assisting three times more patients monthly.

CONCLUSIONS : Our study demonstrates that telemedicine must be considered a valuable health service delivery method for ophthalmologic diagnosis. Understanding its broader value might help local implementation progress, based on market and regional needs. TeleOftalmo has the potential to be a cost-saving strategy for the national health system.