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

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)...

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Autores principales: Kidholm, Kristian, Rasmussen, Maja Kjær, Andreasen, Jan Jesper, Hansen, John, Nielsen, Gitte, Spindler, Helle, Dinesen, Birthe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939376/
https://www.ncbi.nlm.nih.gov/pubmed/26713491
http://dx.doi.org/10.1089/tmj.2015.0194
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author Kidholm, Kristian
Rasmussen, Maja Kjær
Andreasen, Jan Jesper
Hansen, John
Nielsen, Gitte
Spindler, Helle
Dinesen, Birthe
author_facet Kidholm, Kristian
Rasmussen, Maja Kjær
Andreasen, Jan Jesper
Hansen, John
Nielsen, Gitte
Spindler, Helle
Dinesen, Birthe
author_sort Kidholm, Kristian
collection PubMed
description 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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spelling pubmed-49393762016-08-05 Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project Kidholm, Kristian Rasmussen, Maja Kjær Andreasen, Jan Jesper Hansen, John Nielsen, Gitte Spindler, Helle Dinesen, Birthe Telemed J E Health Original Research 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. Mary Ann Liebert, Inc. 2016-07-01 /pmc/articles/PMC4939376/ /pubmed/26713491 http://dx.doi.org/10.1089/tmj.2015.0194 Text en © Kristian Kidholm, et al., 2015; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Research
Kidholm, Kristian
Rasmussen, Maja Kjær
Andreasen, Jan Jesper
Hansen, John
Nielsen, Gitte
Spindler, Helle
Dinesen, Birthe
Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project
title Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project
title_full Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project
title_fullStr Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project
title_full_unstemmed Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project
title_short Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project
title_sort cost-utility analysis of a cardiac telerehabilitation program: the teledialog project
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939376/
https://www.ncbi.nlm.nih.gov/pubmed/26713491
http://dx.doi.org/10.1089/tmj.2015.0194
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