Cost-Effectiveness of Telerehabilitation Compared to Traditional In-Person Rehabilitation: A Systematic Review and Meta-Analysis

 Survivors don't give a flying fuck about cost; what are the recovery results? Are you THAT BLITHERINGLY STUPID?

Cost-Effectiveness of Telerehabilitation Compared to Traditional In-Person Rehabilitation: A Systematic Review and Meta-Analysis 

Aviraj K. Shambushankar • Jobinse Jose • Sridevi Gnasekaran • Gurveen Kaur

Published: February 14, 2025

DOI: 10.7759/cureus.79028

Cite this article as: Shambushankar A K, Jose, Gnasekaran S, et al. (February 14, 2025) Cost-Effectiveness of Telerehabilitation Compared to Traditional In-Person Rehabilitation: A Systematic Review and Meta-Analysis. Cureus 17(2): e79028. doi:10.7759/cureus.79028

Abstract

This systematic review and meta-analysis evaluated the cost-effectiveness of telerehabilitation compared to traditional in-person rehabilitation. A comprehensive search of PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid databases identified 14 eligible studies. The analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, assessing economic outcomes using incremental cost-effectiveness ratios (ICERs) and quality-adjusted life years (QALYs).

Findings indicate that telerehabilitation was cost-effective in three out of 14 studies included in the cost-effectiveness analysis. The mean ICER for telerehabilitation compared to traditional rehabilitation varied, with a probability of cost-effectiveness reaching 90% at a willingness-to-pay (WTP) threshold of $30,000 per QALY. However, at a WTP threshold of $0, the probability of cost-effectiveness remained low, suggesting that telerehabilitation does not always dominate in cost-effectiveness analyses.

The study highlights the potential of telerehabilitation to provide similar or improved health outcomes compared to traditional rehabilitation while reducing travel costs and enhancing patient access. Increased patient satisfaction, reduced hospital readmissions, and improved adherence to rehabilitation protocols contributed to the economic benefits observed. However, methodological heterogeneity across studies remains a limitation.

Given the growing adoption of digital health technologies, telerehabilitation presents a viable and economically efficient alternative to in-person rehabilitation. Policymakers should consider integrating telerehabilitation into routine healthcare services, particularly in resource-constrained settings, to optimize cost-effectiveness and enhance accessibility. Further research should focus on standardizing cost-effectiveness evaluation methods to strengthen evidence for large-scale implementation.

Introduction & Background

Telehealth is any use of technology to communicate and exchange information among patients and health practitioners across a distance [1]. Telerehabilitation is a kind of telehealth intervention where rehabilitation services are offered via phone, the Internet, and remote devices [2]. Rehabilitation has been used in different disease conditions such as schizophrenia [3], diabetes mellitus [4], dementia [5], etc., for a long period. Telerehabilitation is found to be effective in diseases like heart failure [6], stroke [7], hip replacement [8], total knee arthroplasty [9], chronic low back pain [10], breast cancer [11], etc. There has been a huge increase in the use of telehealth globally since COVID-19 [12,13]. Telerehabilitation can improve accessibility [14], utilization of healthcare services [15], improving health outcomes, reducing health inequalities [16], and reducing the waiting time and need for travel [17,18]. It has also improved patient and provider satisfaction and augmented clinical effectiveness [19,20]. Numerous systematic reviews have been conducted to assess the impact of telerehabilitation on patient outcomes [21], while others have examined its effectiveness across various types of healthcare providers [22]. Various studies have been done on the effectiveness of telerehabilitation in different disease conditions, like brain injury [23], stroke [24], and cardiovascular diseases [25].

One of the significant challenges associated with integrating technology into healthcare is the rising cost of healthcare services. Healthcare costs are increasing due to progress in medical technology, demographic aging, an increasing number of healthcare services, and provider-induced demand [26]. Therefore, health providers should have the goal of achieving high-quality services while restraining costs. Economic evaluations like cost-effectiveness analysis (CEA), cost-utility analysis (CUA), and cost-benefit analysis (CBA) play a crucial role in healthcare by systematically assessing the costs and outcomes associated with various interventions. These evaluations help healthcare providers and policymakers make informed decisions to determine which interventions provide the best value for money.

To our knowledge, no published literature comprehensively summarizes the cost-effectiveness of telerehabilitation. This study seeks to thoroughly assess, analyze, and synthesize the published information on the cost-effectiveness of telerehabilitation services. Our objective is to provide a comprehensive overview of the economic impact of telerehabilitation, identifying key areas where telerehabilitation has proven to be cost-effective and highlighting gaps where further research is needed. This will help inform healthcare providers, policymakers, and stakeholders about the potential financial benefits of integrating telerehabilitation into their services and guide future research priorities in this evolving field.

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