This study aims to provide evidence of the economic and environmental dimensions of the tele-assisted home haemodialysis (HHD) services compared to the in-centre, assisted and self-assisted modalities.
A case study approach is used to analyse the different teledialysis modes, with interviews with the staff of the “Vito Fazzi” hospital in Lecce. As for the economic analysis, the authors considered only direct costs (i.e. dialytic services costs and transport services costs), whereas for the environmental analysis, the authors considered CO2 emissions related to transportation and water consumption.
Data analysis revealed that tele-assisted HHD allows for saving costs of each session when compared to in-centre haemodialytic treatments. In particular, economic savings are significant only for self-assisted HHD (SA-HHD) rather than Assisted HHD (A-HHD), reaching percentages of cost reduction going from −38% to −59% when compared to in-centre haemodialytic treatments based on car transport, and from −55% to −67% when compared to in-centre haemodialytic treatments based on ambulance transport. As for environmental sustainability, savings of CO2 emissions and water consumption are more significant for SA-HHD with respect to A-HHD.
The study has some limits mainly related to the typologies of costs considered (e.g. indirect costs are not considered) and the CO2 calculation (e.g. energy consumption is not considered).
The analysis carried out demonstrates a consistent reduction of costs, CO2 emissions and water consumption in case of adoption of SA-HHD treatments, as compared to in-centre dialysis modes. This brings to consider relevant the training of patients and their families to proceed toward a decentralization of dialysis service enabled by digital technologies (Teledialysis – TD) that makes possible the access to SA-HHD.
The paper investigates the economic and environmental dimensions of an emerging telemedicine service that will be largely diffused worldwide in the population in the coming years.
