Cost analysis of telerehabilitation after arthroscopic subacromial decompression

J Telemed Telecare. 2018 Sep;24(8):553-559. doi: 10.1177/1357633X17723367. Epub 2017 Aug 17.

Abstract

Background Subacromial impingement syndrome poses a substantial socioeconomic burden, leading to significant consumption of healthcare. Health systems are calling for greater evidence of economic impacts of particular healthcare services. Telerehabilitation programmes have the potential to reduce costs and improve patient access as an alternative to traditional care. Cost analysis has been traditionally included in study protocols and results, although the reliability and research methodology have frequently been under debate. The aim of this study was to compare costs related to a telerehabilitation programme versus conventional physiotherapy following subacromial decompression surgery (ASD). Methods The study was embedded in a randomised controlled trial. The economic analysis was based on the perspective of the health sector and the human capital method. Only the costs associated with the provision of physiotherapy services were taken into account. Costs were measured during the intervention period between baseline and 12 weeks for both groups. Student's t-test was used to compare independent variables between the two groups, with a 95% confidence interval for the estimates and real costs. Results The estimated total cost analysis shows a preliminary cost differential in favour of the telerehabilitation group, meaning that for each participant's total intervention, telerehabilitation saves 29.8% of the costs. Real cost analysis, only for received treatments, shows a cost differential in favour of telerehabilitation, meaning that for each participant's total intervention, telerehabilitation saves 22.15% of the costs incurred for conventional rehabilitation. Conclusions Our study provides direct and meaningful information about telerehabilitation opportunities and can be an essential component in further cost evaluations for different strategies after surgical procedures. This study demonstrates that there was a trend towards lower healthcare costs after ASD. Managers now have the responsibility to decide whether to implement telerehabilitation based on clinical and economic data.

Keywords: Telerehabilitation; cost analysis; physiotherapy; rehabilitation budget; shoulder impingement syndrome.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroscopy / rehabilitation*
  • Cost-Benefit Analysis
  • Female
  • Health Care Costs
  • Health Services
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities / economics
  • Reproducibility of Results
  • Research Design
  • Shoulder Impingement Syndrome / therapy*
  • Spain
  • Telerehabilitation / economics*
  • Young Adult