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Eur J Prev Cardiol. 2016 May;23(7):674-82. doi: 10.1177/2047487315602257. Epub 2015 Aug 19.

Effect of comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, medical costs and quality of life: A cost-effectiveness analysis.

Author information

1
Department of Cardiology, Jessa Hospital, Hasselt, Belgium Faculty of Medicine & Life Sciences, Hasselt University, Belgium ines.frederix@gmail.com.
2
Faculty of Medicine & Life Sciences, Hasselt University, Belgium.
3
Faculty of Sciences, Expertise Centre for Digital Media, Hasselt University, Belgium.
4
Faculty of Medicine & Life Sciences, Hasselt University, Belgium Department of Cardiology, Hospital East-Limburg, Genk, Belgium.
5
Interuniversity Institute of Biostatistics and Statistical Bioinformatics, Hasselt University, Belgium Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium.
6
Department of Cardiology, Antwerp University Hospital, Belgium.
7
Department of Cardiology, Jessa Hospital, Hasselt, Belgium Faculty of Medicine & Life Sciences, Hasselt University, Belgium.

Abstract

BACKGROUND:

Notwithstanding the cardiovascular disease epidemic, current budgetary constraints do not allow for budget expansion of conventional cardiac rehabilitation programmes. Consequently, there is an increasing need for cost-effectiveness studies of alternative strategies such as telerehabilitation. The present study evaluated the cost-effectiveness of a comprehensive cardiac telerehabilitation programme.

DESIGN AND METHODS:

This multi-centre randomized controlled trial comprised 140 cardiac rehabilitation patients, randomized (1:1) to a 24-week telerehabilitation programme in addition to conventional cardiac rehabilitation (intervention group) or to conventional cardiac rehabilitation alone (control group). The incremental cost-effectiveness ratio was calculated based on intervention and health care costs (incremental cost), and the differential incremental quality adjusted life years (QALYs) gained.

RESULTS:

The total average cost per patient was significantly lower in the intervention group (€2156 ± €126) than in the control group (€2720 ± €276) (p = 0.01) with an overall incremental cost of €-564.40. Dividing this incremental cost by the baseline adjusted differential incremental QALYs (0.026 QALYs) yielded an incremental cost-effectiveness ratio of €-21,707/QALY. The number of days lost due to cardiovascular rehospitalizations in the intervention group (0.33 ± 0.15) was significantly lower than in the control group (0.79 ± 0.20) (p = 0.037).

CONCLUSIONS:

This paper shows the addition of cardiac telerehabilitation to conventional centre-based cardiac rehabilitation to be more effective and efficient than centre-based cardiac rehabilitation alone. These results are useful for policy makers charged with deciding how limited health care resources should best be allocated in the era of exploding need.

KEYWORDS:

Telerehabilitation; cost-effectiveness; telecoaching; telemonitoring

PMID:
26289723
DOI:
10.1177/2047487315602257
[Indexed for MEDLINE]

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