OBJECTIVES: Hemophilia is an inherited bleeding disorder. Hemarthrosis is the most frequent complication of hemophilia results in chronic arthropathy and impaired mobility. The main goal of prophylaxis in hemophilic patients is to prevent anticipated bleeding. Hemophilic Patients are able to recognize their hemorrhage before the manifestation of physical signs. However, studies show that treatment based solely on patients reports of pain, results in over than 60% mistakes in the diagnosis of joint bleedings. Ultrasonography as a reliable facility can be used to document the joint bleeding for starting the bleeding treatment. The main objective of this study was to design an efficient new ambulatory service model for hemophilic patients.

METHODS:

A cost–benefit analysis (CBA) was conducted for comparing the costs with potential savings associated with managing the bleeding condition through a telehealth intervention. This study was done in 3 phases. In phase-I the cost of current services to hemophilic patients in Tehran was evaluated.In phase-II, an ambulatory service model was presented. The type and number of human resources, required equipment, and annual budget were estimated. Validity and reliability of the model were evaluated in phase-III. The analysis of this phase is presented elsewhere.

RESULTS: : The novel service was provided. The Benefit to Cost Ration (BCR) of the ambulatory telehealth service model was 1.19. In sensitivity analysis, the rate of occurred bleeding sensation errors were estimated with 80% mistakes in this study, in fact if the rate of bleeding sensation errors in Iran is about 12%, the model will still be cost beneficial.

CONCLUSIONS:

The implementation of the proposed model can result more than 50% positive financial return to the healthcare system. The one way sensitivity analysis showed that the results are robust and insensitive until 80% reduction of patients’ mistakes in the diagnosis of their joint bleeding.