**3. Results**

As noted in Table 2, between January 2018 and June 2019, a total of 12,322 referrals were made to telemedicine services in the primary care centers which are within the catchment areas of the 2 referral hospitals, avoiding a total of 9034 face-to-face visits. The remaining 3288 telemedicine consultations were referred to a specialist for a face-to-face consultation. Thus, the percentage of face-to-face visits prevented through the use of telemedicine was 73.3%. The most widely used telemedicine service was Teledermatology, with 9352 cases and a reduction in face-to-face visits of 69.66%, followed by Teleaudiometries (2465 cases and a 86.10% reduction in visits), Teleeyelids (350 cases and a 74.6% reduction in visits) and Teleulcers (155 cases and 87.8% reduction in visits).


**Table 2.** Face-to-face visits and visits prevented through telemedicine.

Table 3 shows the distance of saved visits due to the telemedicine program and time and travel cost savings in terms of unused fuel. The average distance of a round trip between a primary care center and the referral hospital was 21.3 km, with an average travel time savings of 25 min. In total, the distance saved was 192,682 km, with a total travel time savings of 3779 h and a total fuel reduction of 11,754 L with an associated cost of €15,664.

**Table 3.** Reduction in journeys by distance, time, fuel and cost. Cost of fuel available at: https: //www.dieselgasolina.com (Accessed on: 17 September 2019).


A breakdown of the reduction in the emissions of pollutants is shown in Table 4. Total reduction in pollutants is 29.384 tonnes of carbon dioxide, 36.61 kg of carbon monoxide, 43.93 kg of nitric oxide and 28.9 kg of sulphur dioxide. This represents an average reduction of 3248.3 g of carbon dioxide, 4.05 g of carbon monoxide, 4.86 g of nitric oxide and 3.2 g of sulphur dioxide.


**Table 4.** Reduction in the emissions of pollutant gases.
