Quantifying the Cost-Benefit of In-Person Dermatologic Care Versus Teledermatology in Urban and Rural Settings

¹University of Missouri School of Medicine, Columbia, MO, United States

²St. John’s Episcopal Hospital, Far Rockaway, NY, United States

³HCA Florida Lawnwood Hospital, Fort Pierce, FL, United States

⁴Drexel University College of Medicine, PA, United States

⁵Wright State University Boonshoft School of Medicine, Dayton, OH, United States

⁶Emory University Goizueta Business School, Atlanta, GA, United States

⁷Rutgers Robert Wood Johnson School of Medicine, NJ, United States

⁸Department of Dermatology, Northwell Health, New Hyde Park, NY, United States

*Corresponding author: Kelly Frasier, DO, MS, Department of Dermatology, Northwell Health, New Hyde Park, NY, United States, Phone: 3105956882, Email: [email protected]

Received Date: July 14, 2025

Publication Date: September 09, 2025

Citation: Jackson T, et al. (2025). Quantifying the Cost-Benefit of In-Person Dermatologic Care Versus Teledermatology in Urban and Rural Settings. Dermis. 5(5):47.

Copyright: Jackson T, et al. © (2025).

ABSTRACT

Teledermatology represents a technologically mediated reconfiguration of dermatologic service delivery, offering an alternative to in-person care that varies in clinical utility and economic value across geographic and sociodemographic contexts. In urban settings, where dermatologic specialists are densely concentrated and procedural infrastructure is readily available, in-person visits facilitate higher diagnostic resolution and immediate intervention, particularly for neoplastic and surgically managed conditions. However, the direct and indirect costs associated with in-person care such as patient travel time, missed work, and delayed appointment availability present inconvenient burdens, especially in systems with long wait times or fragmented referral networks. In rural and resource-limited areas, teledermatology offers a mechanism to circumvent geographic isolation and workforce scarcity, with store-and-forward and synchronous models demonstrating high diagnostic concordance for common inflammatory, pigmentary, and infectious dermatoses. Cost-effectiveness is maximized in scenarios involving high-volume, low-complexity consultations, particularly when digital platforms are integrated with interoperable electronic health records and triage protocols that direct patients to in-person care only when necessary. Despite these advantages, limitations persist in the virtual assessment of tactile or morphologically subtle lesions, preoperative planning, and conditions requiring real-time clinical judgment beyond what static images or brief synchronous interactions can support. Economic outcomes are further shaped by variables such as digital literacy, broadband access, patient age, insurance coverage, and language concordance, which impact the feasibility and acceptability of virtual care. Teledermatology is not a universal substitute for in-person care, but a modality contingent upon alignment with clinical acuity, infrastructural readiness, and patient-specific needs. A stratified cost-benefit analysis incorporating clinical effectiveness, health equity, and system-level resource allocation demonstrates teledermatology offers greatest value when applied to low-complexity conditions, situated within well-integrated health systems, and used in populations where it reduces barriers to timely, appropriate dermatologic evaluation without compromising diagnostic precision or care continuity.

Keywords: Teledermatology, Healthcare System, Dermatopathology, Skin Conditions, Oncology