Questions
Is remotely delivered physiotherapy cost saving when compared with usual face-to-face physiotherapy as typically provided in a public hospital outpatient setting? Is remotely delivered physiotherapy cost-effective?
Design
Economic evaluation embedded within a randomised controlled, non-inferiority trial using a health system plus patient perspective.
Participants
Patients with musculoskeletal conditions presenting to Sydney public hospitals for physiotherapy treatment.
Intervention
REFORM was a randomised controlled trial comparing remotely delivered physiotherapy with usual care provided in an outpatient setting. Remotely delivered physiotherapy involved one face-to-face physiotherapy session in conjunction with text messages, phone calls and an individualised exercise program delivered through an ‘App’.
Outcome measures
The economic evaluation included the Patient Specific Functional Scale at 6 weeks in the cost-minimisation and cost-effectiveness analyses, and quality-adjusted life years (QALYs) at 26 weeks in the cost-utility analysis. Health system and patient resource use were derived from patient self-report.
Results
Costs per participant over 6 weeks were AUD $742 for remotely delivered physiotherapy and $910 for face-to-face physiotherapy, with a mean cost difference of –$168 (95% CI –$339 to $1). There was a 98% probability of remotely delivered physiotherapy being cost saving within the non-inferiority margin of the Patient Specific Functional Scale, and an 88% probability of being dominant to face-to-face physiotherapy (less costly and more effective). There was a 51% probability of being cost-effective at a nominal $50,000/QALY threshold.
Conclusion
Moving people with musculoskeletal conditions to a remote model of physiotherapy care is potentially cost saving for health systems and patients, without compromising health outcomes when compared with currently provided public hospital care.
Trial registration
ACTRN12619000065190.
扫码关注我们
求助内容:
应助结果提醒方式:
