OBJECTIVES: Digital health apps provide a platform for remote follow-up care in orthopedic and trauma surgery. We aim to analyze the cost-effectiveness of a digital health app for follow-up care after specific shoulder and knee surgeries and conservative treatments in a German university hospital setting. We aim to compare the digital health app to conventional face-to-face consultations. We conduct our analysis from both a health care provider perspective and a societal perspective.

METHODS: We set up a randomized controlled trial, offering patients either a follow-up appointment by digital health app (intervention group) or face-to-face in the hospital (control group). We record treatment costs, time spent by physicians and time spent by patients, including travel costs to the hospital, and patient utility. We compare costs and patient utility for the intervention group and the control group and analyze the app's cost-effectiveness for the health care provider and for society.

RESULTS: The health economic analysis based on data from 52 patients revealed a break-even point of 26 video consultations per month from a health care provider perspective. After 26 video consultations, reduced personnel costs amortize the costs for the digital health app from a health provider perspective. Furthermore, from a societal perspective, patients were found to save travel costs, time costs and production losses, resulting in mean cost savings of €75.99 per video consultation compared with a clinic consultation.

CONCLUSIONS: Follow-up care with a digital health app is less time consuming for physicians compared to conventional clinic consultations, resulting in cost savings for clinics without having a negative impact on patient utility. In addition to the benefits from a health care provider perspective, the digital health app saves travel costs and patient time, i.e. it helps to lower production losses from a societal perspective.