The burden of attending a pediatric surgical clinic and family preferences toward telemedicine

J Pediatr Surg. 2015 Oct;50(10):1776-82. doi: 10.1016/j.jpedsurg.2015.06.005. Epub 2015 Jun 20.


Background/purpose: Indirect expenses for accessing health care may place significant fiscal strain on Canadian families. Telemedicine alternatives, using email, telephone, and video conferencing, can mitigate such financial burdens by reducing travel and related costs. Our objectives were to assess costs that families incur visiting an outpatient pediatric surgical clinic, and family attitudes toward telemedicine alternatives.

Methods: A survey was offered pre-consult to all families who attended pediatric urology and general surgery outpatient clinics over a three-month period.

Results: A total of 1032 of 1574 families screened participated (66.0%). Less than half (18.5%) of participants traveled over 200 km, and 32.9% spent over 4 hours in transit, round-trip. The proportion of participants who spent over $50 on travel and ancillary expenses was 33.0%. In 74.0% of families, 1 or more adults missed work. The proportion of families who perceived costs as somewhat high or high was 29.1%. Perceived cost was positively correlated to distance traveled, money spent, and missed work (p<0.01). Most were comfortable with medical communication using technology; and 34.3%-42.7% would avoid an in-person clinic visit utilizing email, telephone, and video conferencing. Higher perceived cost (p<0.001) and distance traveled (p<0.01) were only weakly associated with greater willingness to substitute a clinic visit with video conferencing.

Conclusions: Many families face high costs related to routine outpatient clinical visits, and there is a substantial willingness by them to access telemedicine alternatives, rather than the traditional face-to-face clinical visit.

Keywords: Burden; Cost; Pediatrics; Surgery; Telemedicine; Urology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulatory Care / economics*
  • Ambulatory Care Facilities / economics*
  • Attitude to Health*
  • Canada
  • Child
  • Family*
  • Female
  • General Surgery
  • Health Expenditures
  • Health Services Accessibility / economics*
  • Humans
  • Male
  • Pediatrics
  • Referral and Consultation / economics
  • Surveys and Questionnaires
  • Telemedicine*
  • Travel / economics
  • Urology