Abstract
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, socioeconomic profile, travel, and costs (transport and food). Avoided distance, time, and pollutant emissions were calculated using Google Maps and emission factors. The preference for telemedicine was correlated with socioeconomic data. Statistical analyses used Wilcoxon, chi-square, and logistic regression tests. RESULTS: 148 patients were included, of whom 77.7% preferred telemedicine. The mean round-trip distance avoided was 168.84 km, and the mean time saved was 223.97 minutes. Estimated out-of-pocket savings were USD 12.62 for public transport users and USD 28.95 for private car users. Telemedicine also reduced emissions by approximately seven metric tons of carbon dioxide in total. Higher income was positively associated with telemedicine preference (p=0.0283); other variables showed no significant associations. CONCLUSION: Telemedicine reduced time, costs, and emissions, improving access. Preference was higher among wealthier patients, indicating barriers for low-income groups. Further studies should explore low adherence among socioeconomically disadvantaged populations. Level of Evidence IV; Economic and Decision Analysis.