Postoperative remote first care for financially and environmentally sustainable healthcare.

Lathan, Ross; Hitchman, Louise; Walshaw, Josephine; Ravindhran, Bharadhwaj; Carradice, Daniel; Smith, George; Chetter, Ian; Yiasemidou, Marina · NPJ Digit Med · 2025

prospective_cohort · Level II

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Abstract

This study aims to quantify the financial and environmental savings associated with remote follow up in patients undergoing lower limb arterial surgery. A prospective observational study evaluating financial cost(fC) and environmental cost(eC) of postoperative follow-up models. Remote-first screening(RFS), where all patients were reviewed remotely, and complications triaged for face-to-face assessment and treatment. The second model was remote-first treatment(RFT): all patients were reviewed remotely, but only high-risk complications trigger face-to-face review. Both were compared with conventional face-to-face review. All participants received both face-to-face and remote review. 105 patients were included. RFS has a per patient mean reduction of 30.8.0±26.2 kgCO<sub>2</sub>e(RR 71.0%, p < 0.001) and fC reduction of £60.17±42.98(RR 87.0%, p < 0.001). RFT has a mean reduction of 38.5±17.4 kgCO<sub>2</sub>e(RR 88.8%, p < 0.001) and fC reduction of £83.29±45.51(RR 87.0%, p < 0.001). Remote models demonstrated economic and environmental gains over routine face-to-face assessments. Integration of these analyses into health intervention assessment is important to reducing climate change.