Evaluating the Cost Effectiveness of Tele-Rehabilitation: A Systematic Review of Randomized Clinical Trials

Abstract

Introduction: Despite the epidemic of Covid 19, the current budget constraints of governments do not allow to increase the budget of conventional rehabilitation programs. As a result, there is a growing need for cost-effective alternative strategies such as tele-rehabilitation. Therefore, the purpose of this study was a systematic review of randomized clinical trial studies to evaluate the cost-effectiveness of tele-rehabilitation.Materials and Method: A systematic review, without time limit, was searched by searching for keywords in the title, abstract and keywords of studies in the authoritative scientific databases Embase, Web of Science, Scopus, PubMed on November 24, 2021. Randomized and controlled trial studies that used the Tele-rehabilitation approach as an intervention in the study and evaluated it in terms of cost-effectiveness were considered as inclusion criteria. Eligibility criteria were screened independently by two researchers. In order to evaluate the quality of the input studies to this study, the JBI quality evaluation checklist for randomized controlled trials was used. The same checklist was used to extract the data. The data elements in this checklist included the title of the publication, year of publication, country, number of participants, duration of intervention, technology-based approach, study population, study objectives and main findings of the study.Results: A total of 11 articles with inclusion criteria were included in the study. There was no significant bias in the studies and all studies had the quality of inclusion in our study. The Tele-rehabilitation approaches and health conditions evaluated in the studies were largely different. In (5.11, 45%) of the studies, Tele-rehabilitation interventions reported a significant improvement in the outcomes and clinical effects in the Tele-rehabilitation group versus the control group (face-to-face visit). In (7.11, 64%) of the studies, Tele-rehabilitation interventions were more cost effective than traditional rehabilitation interventions. However, in (4.11, 36%) of the studies, no significant difference was observed in the amount of money spent between the control and intervention groups. In addition, in 4 of the studies, no significant improvement in quality in the adjusted years was reported.Conclusion: The evidence from this study shows that Tele-rehabilitation services and care for the general public are more cost effective than face-to-face rehabilitation services. It is suggested that future studies to maximize the potential of tele-rehabilitation focus on improving patients' access to rehabilitation services and removing barriers to tele-rehabilitation.