OBJECTIVES

: This study examines the cost effectiveness of an augmented physiotherapy programme (APEP) for elderly inpatients in an acute setting. Functional decline in the older adult can occur with an acute hospital stay, leading to increased healthcare burden and morbidity. Physiotherapy programmes can improve mobility and well-being.

METHODS

: A cost effectiveness analysis, adopting a health care provider perspective, was conducted comparing APEP to a SHAM. Costs of APEP and SHAM included physiotherapist time only. APEP consisted on average of 7 physiotherapy sessions (SD 5) over the duration of time spent in hospital per patient with each session lasting on average 16 mins. Meanwhile the SHAM consisted of an average of 6.6 physiotherapy sessions (SD. 4.4) over the duration of time spent in hospital per patient. Each session took on average 12 mins. Each intervention was delivered by a senior physiotherapist. With regards to effectiveness, the EQ-5D-5L was administered to participants at admission and follow-up to estimate quality of life measure in utilities. A probabilistic sensitivity was performed to investigate uncertainty. Results presented on an incremental cost effectiveness plane and cost effectiveness acceptability curve.

RESULTS

: On a per patient basis the average cost of APEP was €82.27 and SHAM was €58.18 per hospital episode. The APEP resulted in a 0.27 improvement in utility and in SHAM a 0.24 improvement between admission and 3 month follow-up. When incremental costs and effects are considered, APEP was found to be more expensive and more effective than the SHAM. There is uncertainty surrounding the existence and extent of differences in costs and effects and some decision uncertainty. However, across a range of ceiling ratios the probability of APEP being cost effective is always greater compared with SHAM.

CONCLUSIONS

: This cost effectiveness analysis demonstrates the potential for APEP to be considered cost effective compared with a SHAM.