CLINICAL AND COST-EFFECTIVENESS OF HOME-BASED PHYSIOTHERAPY FOR ADULT STROKE REHABILITATION: A SYSTEMATIC REVIEW
Author(s)
Ruchika Bire, MPH1, Dhaval Parmar, PhD2, Devang R. Raval, MPH2, Somen Saha, PhD2, Archana Thakur, MD2, Juhi Thakur, MPH1, Junaid KP, PhD1, Krushnachandra Sahoo, PhD3, Deepak B. Saxena, PhD2, Kavitha Rajsekar, PhD4.
1Indian Institute of Public Health Gandhinagar, Gandhi Nagar, India, 2Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 3Ministry of Health and Family Welfare, Delhi, India, 4DHR, Ministry of Health and Family Welfare, New Delhi, India.
1Indian Institute of Public Health Gandhinagar, Gandhi Nagar, India, 2Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 3Ministry of Health and Family Welfare, Delhi, India, 4DHR, Ministry of Health and Family Welfare, New Delhi, India.
OBJECTIVES: To evaluate the clinical outcomes and cost-effectiveness of home-based physiotherapy for adult stroke rehabilitation.
METHODS: A systematic review of randomized controlled trials and economic evaluations on home-based physiotherapy interventions for adult stroke survivors was conducted. Out of 24,855 records screened, seven studies met the inclusion criteria. The studies compared home-based rehabilitation with hospital-based rehabilitation, stroke unit care, or usual care. Clinical outcomes included functional independence, mobility, activities of daily living, and quality of life. Economic outcomes covered healthcare costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). Due to differences among the studies, findings were summarized narratively.
RESULTS: Seven studies were included, comprising of four clinical studies and three economic evaluations. Clinical trials revealed that home-based rehabilitation had functional outcomes comparable to hospital-based rehabilitation, with improvement reported in mobility, activities of daily living, and quality of life. Reduced hospital stay and successful community reunification were also observed. Economic evaluations consistently reported lower overall healthcare costs associated with home-based rehabilitation. One study demonstrated higher QALYs and lower costs with home-based rehabilitation. At the same time, another identified domiciliary care as the least costly rehabilitation strategy, regardless of the superior outcomes observed with stroke unit care at a higher cost.
CONCLUSIONS: Home-based physiotherapy seems to be a clinically effective and cost-effective rehabilitation approach for adult stroke survivors. The findings support its potential to lower healthcare costs while ensuring functional recovery results.
METHODS: A systematic review of randomized controlled trials and economic evaluations on home-based physiotherapy interventions for adult stroke survivors was conducted. Out of 24,855 records screened, seven studies met the inclusion criteria. The studies compared home-based rehabilitation with hospital-based rehabilitation, stroke unit care, or usual care. Clinical outcomes included functional independence, mobility, activities of daily living, and quality of life. Economic outcomes covered healthcare costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). Due to differences among the studies, findings were summarized narratively.
RESULTS: Seven studies were included, comprising of four clinical studies and three economic evaluations. Clinical trials revealed that home-based rehabilitation had functional outcomes comparable to hospital-based rehabilitation, with improvement reported in mobility, activities of daily living, and quality of life. Reduced hospital stay and successful community reunification were also observed. Economic evaluations consistently reported lower overall healthcare costs associated with home-based rehabilitation. One study demonstrated higher QALYs and lower costs with home-based rehabilitation. At the same time, another identified domiciliary care as the least costly rehabilitation strategy, regardless of the superior outcomes observed with stroke unit care at a higher cost.
CONCLUSIONS: Home-based physiotherapy seems to be a clinically effective and cost-effective rehabilitation approach for adult stroke survivors. The findings support its potential to lower healthcare costs while ensuring functional recovery results.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
RWD17
Topic
Real World Data & Information Systems
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)