Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project.

Authors:
Kristian Kidholm
Kristian Kidholm
Odense University Hospital
Denmark
Jan Jesper Andreasen
Jan Jesper Andreasen
Aalborg Hospital
Denmark
John Hansen
John Hansen
University of Washington
United States
Gitte Nielsen
Gitte Nielsen
Aarhus University Hospital
Denmark
Helle Spindler
Helle Spindler
Aarhus University
Aarhus | Denmark
Birthe Dinesen
Birthe Dinesen
Aalborg University
Denmark

Telemed J E Health 2016 07 29;22(7):553-63. Epub 2015 Dec 29.

7 Telehealth and Telerehabilitation, Laboratory of Assistive Technologies, SMI ®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University , Aalborg, Denmark .

Background: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR) program. The aim of the intervention was to increase the patients' participation in the CTR program. At discharge, an individualized 3-month rehabilitation plan was formulated for each patient. At home, the patients measured their own blood pressure, pulse, weight, and steps taken for 3 months.

Materials And Methods: The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form Health Survey.

Results: The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was €1,700 higher in the intervention group. The quality-adjusted life-years (QALYs) gain was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than €400,000 per QALY gained.

Conclusions: Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself was not costly (less than €500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.

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Source
https://www.liebertpub.com/doi/10.1089/tmj.2015.0194
Publisher Site
http://dx.doi.org/10.1089/tmj.2015.0194DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939376PMC

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July 2016
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