Travel Costs and Carbon Savings Associated With Telemedicine in a Tertiary Care Rhinology Center

Objective: Healthcare-associated costs as well as carbon dioxide (CO₂) emissions are rising, and identifying means to mitigate these may provide direct benefits to patients as well as overall population health, especially among patients with chronic sinonasal disease. This study aimed to assess potential personal travel costs and CO₂ emissions saved due to telemedicine visits. Methods: This was a retrospective review of patients within Oregon presenting for telemedicine visits at a tertiary rhinology center from July 2022 to July 2023. Distance from patient's address to clinic (miles), as well as estimated average travel time (min), travel costs (USD), and CO₂ emissions (kg), were calculated per round trip prevented by providing care at a distance. Area deprivation indices (ADI) were obtained based on nine-digit zip codes. Results: Among 354 included visits, the mean ± standard deviation (SD) age was 57.03 ± 16.58 years. Chronic rhinosinusitis (CRS) was the most common diagnosis (55.4%). The majority of visits were follow-up (65.5%) or preoperative (26.8%). Approximately 64,977.00 miles and 66,988.67 min (∼1,116 h) of roundtrip travel were saved, reducing CO₂ emissions by 26,705.55 kg (equivalent to 3,005 gallons of gasoline consumed or 5.6 homes’ electricity use for 1 year). Patients within the highest ADI quartile (Q), indicating highest socioeconomic disadvantage, had the highest travel costs saved (median [interquartile range]; Q1, $12.24 [$18.36]; Q2, $134.33 [$274.38]; Q3, $256.69 [$191.52]; Q4, $364.42 [$154.28]; p < 0.001). Conclusions: Telemedicine may facilitate reduction in the carbon footprint associated with healthcare as well as reduce indirect healthcare costs associated with travel.