Cost Analysis of Telemedicine vs. In-Person Consultations of Stroke Patients inPrimary Healthcare

Background: To evaluate the perceived costs and feasibility of telemedicine consultations, compared with in-person consultations among patients with stroke, in primary healthcare settings in Pakistan.The study aimed to assess the potential costs and time savings to provide evidence-based information to inform decisions for the implementation of telemedicine in a lowresource environment. Methods:A cross-sectional survey design was used, involving a convenience sample of 30 stroke patients recruited from Al Nafees Medical College and Hospital, Islamabad, and Ikram Hospital, Gujrat.Data was collected through a structured survey which captured patient demographics, patient clinical characteristics, cost of in-person consultations, technology access, and perceived costs of telemedicine consultations.Independent t-tests were used to compare mean costs and time differences between in-person and telemedicine consultation models.Significance was set at p < 0.05. Results:The average total cost of an in-person consultation was PKR 7,4402,680, while telemedicine was estimated to cost around PKR 1,200 480, representing an average cost saving of PKR 6,240 2,300 (p< 0.001).In addition, telemedicine consultations reduced consultation time from 6.83.2 hours to 1.20.6 hours (p< 0.001).The vast majority of families (93.3%) felt that telemedicine would be both time and cost-efficient, with particularly strong support from families residing in rural areas, who faced higher travel and overnight accommodation costs. Conclusion:The study revealed that telemedicine may increase equity in access to services for patients, and will reduce the economic burden on families, while increasing access to services, which presents a strong rationale for its inclusion in national stroke management systems low-and middle-income countries.