Original Article

Cost reduction associated with telemedicine evaluation of low-risk orthopedic assessment: A cost-minimization analysis

¹ Hospital Israelita Albert Einstein, São Paulo, Brazil
² Economia da Saúde, Hospital Israelita Albert Einstein, São Paulo, Brazil
³ Departamento de Telemedicina, Hospital Israelita Albert Einstein, São Paulo, Brazil

^* Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Received: 3 February 2026
Accepted: 10 May 2026

Abstract

Introduction: Despite the growing adoption of teleorthopedics, predominantly targeting low-complexity cases, the cost-minimization potential of this approach remains insufficiently characterized. Methods: The study employed a cost-minimization analysis to compare telemedicine triage against conventional in-person care for orthopedic patients in a private hospital in São Paulo, Brazil. The analysis focused on cost as the primary outcome, assuming clinical equivalence between interventions. The perspective was hospital-based, considering operational expenses in the emergency department. Data were derived from historical cost records using absorption costing. A decision tree model was developed using TreeAge Pro 2024, and a sensitivity analysis was conducted to evaluate cost variations. Results adhered to CHEERS guidelines and ISPOR economic reporting standards. Results: The economic analysis revealed an average cost reduction of 48% (US$ 130.00) associated with teleorthopedics, with sensitivity analysis indicating potential 22 savings ranging from 25% (US$ 72.00) to 54% (US$ 146.00). The financial benefit was most pronounced in clinical pathways without diagnostic testing, with a 0.78 probability of cost savings compared to standard care. The consultation duration and telemedicine operational costs are the most influential factors in the cost–benefit outcome. Conclusion: Teleorthopedics demonstrates substantial cost-saving potential, particularly in scenarios without diagnostic testing. Consultation duration and operational costs emerge as key economic drivers.