Economic and environmental impacts of Telemedicine: insights from a Brazilian orthopedic referral center

Economic and environmental impacts of Telemedicine: insights from a Brazilian orthopedic referral center | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Economic and environmental impacts of Telemedicine: insights from a Brazilian orthopedic referral center Fabio Seiji Mazzi Yamaguchi, Hector Fugihara Kroes, Gabriel Benevides Valiate Martins, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5567735/v2 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Nov, 2025 Read the published version in Acta Ortopédica Brasileira → Version 2 posted You are reading this latest preprint version Show more versions Abstract Introduction: Telemedicine has emerged as a key tool to overcome socioeconomic disparities, expand healthcare access, and reduce environmental impacts. Its adoption surged during the COVID-19 pandemic, minimizing travel-related barriers and ensuring continuity of care. In Brazil, where regional inequities in healthcare access and pollution heavily affect public health, telemedicine holds significant promise. However, further research is needed to quantify its economic and environmental benefits. Moreover, examining how socioeconomic factors influence patients' preferences for telemedicine is essential. These correlations help identify patterns that may influence telemedicine adoption and provide deeper insights into how socioeconomic factors can affect access to and benefits from remote healthcare services. Objective: To evaluate the economic and environmental impacts of telemedicine use and the correlation of socioeconomic variables with telemedicine preference in patients with hip pathologies at a tertiary referral center in São Paulo, Brazil. Methods: A cross-sectional study (January-June 2024) analyzed telemedicine patients, collecting data on preferences, demographics, travel, and costs (transport and food). Avoided distance, time, and pollutant emissions were calculated using Google Maps and emission factors. Correlations were conducted between patients' preference for telemedicine and their socioeconomic data. Statistical analyses used Wilcoxon, chi-square, and logistic regression tests. Results: 148 patients participated, with 77.7% preferring telemedicine. The mean avoided travel distance was 168.84 km, with a mean time saving of 223.97 minutes. Patients using public transport and private cars saved, respectively, USD 12.62 and USD 28.95. Telemedicine also reduced pollutant emissions, avoiding approximately 7 tons of carbon dioxide. Telemedicine preference was positively associated with higher income (p = 0.0283). Other variables showed no statistically significant associations. Conclusion: Telemedicine led to significant time and cost savings, as well as a reduction in pollutant emissions. These findings demonstrate telemedicine’s potential to improve access and reduce environmental impacts. Preference for telemedicine was positively associated with higher income, highlighting potential barriers for lower-income populations. Further research is needed to address the lower adherence to virtual consultations among socioeconomically disadvantaged groups. Orthopedics Telemedicine Accessibility to Health Care Cost-Benefit Analysis Vehicle Emissions Orthopedics Air Pollutants Figures Figure 1 Figure 2 Figure 3 Figure 4 Full Text Additional Declarations The authors declare no competing interests. Supplementary Files Table1.png Table 1: Data on travel to IOT-HCFMUSP divided by consultation modality preference Table2.png Table 2: Socioeconomic elements divided by consultation modality preference Table3.png Table 3: Emissions avoided by implementing Telemedicine consultation strategy divided by mode of transportation Cite Share Download PDF Status: Published Journal Publication published 30 Nov, 2025 Read the published version in Acta Ortopédica Brasileira → Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5567735","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":386502409,"identity":"b4c3122b-f01e-4d22-a2ac-ac8b6af2895d","order_by":0,"name":"Fabio Seiji Mazzi 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Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Telemedicine, Accessibility to Health Care, Cost-Benefit Analysis, Vehicle Emissions, Orthopedics, Air Pollutants","lastPublishedDoi":"10.21203/rs.3.rs-5567735/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5567735/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction: \u003c/strong\u003eTelemedicine has emerged as a key tool to overcome socioeconomic disparities, expand healthcare access, and reduce environmental impacts. Its adoption surged during the COVID-19 pandemic, minimizing travel-related barriers and ensuring continuity of care. In Brazil, where regional inequities in healthcare access and pollution heavily affect public health, telemedicine holds significant promise. However, further research is needed to quantify its economic and environmental benefits. Moreover, examining how socioeconomic factors influence patients' preferences for telemedicine is essential. These correlations help identify patterns that may influence telemedicine adoption and provide deeper insights into how socioeconomic factors can affect access to and benefits from remote healthcare services.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eTo evaluate the economic and environmental impacts of telemedicine use and the correlation of socioeconomic variables with telemedicine preference in patients with hip pathologies at a tertiary referral center in São Paulo, Brazil.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA cross-sectional study (January-June 2024) analyzed telemedicine patients, collecting data on preferences, demographics, travel, and costs (transport and food). Avoided distance, time, and pollutant emissions were calculated using Google Maps and emission factors. Correlations were conducted between patients' preference for telemedicine and their socioeconomic data. Statistical analyses used Wilcoxon, chi-square, and logistic regression tests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003e148 patients participated, with 77.7% preferring telemedicine. The mean avoided travel distance was 168.84 km, with a mean time saving of 223.97 minutes. Patients using public transport and private cars saved, respectively, USD 12.62 and USD 28.95. Telemedicine also reduced pollutant emissions, avoiding approximately 7 tons of carbon dioxide. Telemedicine preference was positively associated with higher income (p = 0.0283). Other variables showed no statistically significant associations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Telemedicine led to significant time and cost savings, as well as a reduction in pollutant emissions. These findings demonstrate telemedicine’s potential to improve access and reduce environmental impacts. Preference for telemedicine was positively associated with higher income, highlighting potential barriers for lower-income populations. Further research is needed to address the lower adherence to virtual consultations among socioeconomically disadvantaged groups.\u003c/p\u003e","manuscriptTitle":"Economic and environmental impacts of Telemedicine: insights from a Brazilian orthopedic referral center","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2024-12-06 15:50:40","doi":"10.21203/rs.3.rs-5567735/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2024-12-05 06:32:01","doi":"10.21203/rs.3.rs-5567735/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a98ac0f4-5115-454c-aefc-2ce178f1a953","owner":[],"postedDate":"December 6th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":41199589,"name":"Orthopedics"}],"tags":[],"updatedAt":"2025-12-08T16:08:19+00:00","versionOfRecord":{"articleIdentity":"rs-5567735","link":"https://doi.org/10.1590/1413-785220253303e296058","journal":{"identity":"acta-ortopedica-brasileira","isVorOnly":true,"title":"Acta Ortopédica Brasileira"},"publishedOn":"2025-12-01 00:00:00","publishedOnDateReadable":"December 1st, 2025"},"versionCreatedAt":"2024-12-06 15:50:40","video":"","vorDoi":"10.1590/1413-785220253303e296058","vorDoiUrl":"https://doi.org/10.1590/1413-785220253303e296058","workflowStages":[]},"version":"v2","identity":"rs-5567735","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5567735","identity":"rs-5567735","version":["v2"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}