A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective

A randomized controlled trial was carried out to measure the cost-effectiveness of realtime teledermatology compared with conventional outpatient dermatology care for patients from urban and rural areas. One urban and one rural health centre were linked to a regional hospital in Northern Ireland by ISDN at 128 kbit/s. Over two years, 274 patients required a hospital outpatient dermatology referral -126 patients (46%) were randomized to a telemedicine consultation and 148 (54%) to a conventional hospital outpatient consultation. Of those seen by telemedicine, 61% were registered with an urban practice, compared with 71% of those seen conventionally. The clinical outcomes of the two types of consultation were similar - almost half the patients were managed after a single consultation with the dermatologist. The observed marginal cost per patient of the initial realtime teledermatology consultation was f52.85 for those in urban areas and f59.93 per patient for those from rural areas. The observed marginal cost of the initial conventional consultation was f47.13 for urban patients and f48.77 for rural patients. The total observed costs of teledermatology were higher than the costs of conventional care in both urban and rural areas, mainly because of the fixed equipment costs. Sensitivity analysis using a real-world scenario showed that in urban areas the average costs of the telemedicine and conventional consultations were about equal, while in rural areas the average cost of the telemedicine consultation was less than that of the conventional consultation.

Do economists ‘compose’ economics? A comparison of the creative processes of artists and economists

This is a draft for a chapter of the book version of my Ph.D thesis. The chapter addresses the following question: Are the creative processes of musical composers and academic economists essentially the same, or are there significant differences? The paper finds that there are deep similarities between the creative processes of theoretical economists and the creative processes of artists. The chapter builds a process oriented lifecycle account of creative activity, drawing on testimonial material from the arts and the sciences, and relates the model to the creative work of economists developing economic theory.

Family orientated delivery of routine nursing care in hospital

Hospital nursing may be better deployed to acute clinical patient care. The recruitment of family assistance will facilitate this process in patients in hospital awaiting placement and without acute care issues.

Economics, wildlife tourism and conservation: Three case studies

This report presents the results of an economics component of the National Interdisciplinary Project (NIP) on wildlife tourism in Australia. The main objectives of the study were to outline and assess the role that economics can play in the valuation and management of wildlife-based tourism, undertake appropriate case studies to highlight the value of economics and its limits in assessing wildlife tourism in each case, take into account relevant environmental issues involved in wildlife tourism, and make future recommendations.

Economics, Wildlife Tourism and Conservation: Three Case Studies

This report presents the results of an economics component of the National Interdisciplinary Project (NIP) on wildlife tourism in Australia. The main objectives of the study were to outline and assess the role that economics can play in the valuation and management of wildlife-based tourism, undertake appropriate case studies to highlight the value of economics and its limits in assessing wildlife tourism in each case, take into account relevant environmental issues involved in wildlife tourism, and make future recommendations.