OBJECTIVES:

To assess CEA of TR post-THA compared to standard of care

METHODS:

Data Source

• Peer-reviewed published literature

Design

• A decision model mapping out rehabilitation services each patient that enters will either receive SR or TR.
• Model assumed a societal perspective taking into account costs of THA, comparing SR services within the post-acute period.
• Willingness to pay was set to zero.
• Time horizon: 90 days to capture adverse events within post-acute time frame.

Measures

• Inputs include costs of emergency room, average medication costs, travel costs to outpatient clinic, mortality rate after THA and adherence to physical therapy as prescribed
• Adherence in this model is a proxy to demonstrate patient preference and therefore utility for the patient

Statistical Analysis

All analyses were done using the TreeAge 2017 (TreeAge Pro v17.2.1.0 Mac)

RESULTS:

Initial results based on a one-way sensitivity analysis demonstrates probability of adherence has large effect on outcomes, patient going to ER has the most influence on model outputs. Point estimate or estimated incremental cost effectiveness ration when comparing TR to SR at $14,875 over a 90 day time horizon.

CONCLUSIONS:

This model demonstrates TR has potential to improve patient outcomes and reduce costs by increasing adherence and satisfaction. Value demonstrated with this model focuses on effectiveness or adherence, and as telerehabilitation becomes similar to the more expensive treatment option, then how can we leverage this lower cost of delivery and improve implementation.