Cardiac Telerehabilitation Reduces Healthcare Costs by Decreasing Cardiovascular Re-Hospitalization Rate

Abstract

Background Notwithstanding the cardiovascular disease epidemic, current budgetary constraints do not allow for budget expansion of conventional cardiac rehabilitation (CR) programs. Thus, there is an increasing need for cost-effectiveness studies of alternative strategies such as telerehabilitation; the results of one of such studies are presented here. Methods This multi-centre randomized controlled trial comprised 140 cardiac patients, randomized (1:1) to a 24-week telerehabilitation program in addition to conventional CR (intervention group) or to conventional CR alone (control group). The costs evaluation took into account both intervention and health care resource costs. Intervention costs were those associated with delivering the centre-based CR and telerehabilitation program. INAMI/RIZIV’s nomenclature-based tariffs were employed to quantify the centre-based CR costs. Expenditure records were used to determine the equipment and consumable resources for telerehabilitation. Health care costs were the aggregated costs of the cardiovascular rehospitalizations and also specialist visits and associated diagnostics. The cardiovascular rehospitalizations’ related costs were derived from invoices retrieved from the recruiting hospitals’ financial departments. INAMI/RIZIV’s nomenclature-based tariffs defined specialist visits and diagnostics denominations. Results The total average cost per patient (intervention plus health care costs) was significantly lower in the intervention group (2156 ± 126 €) than in the control group (2720 ± 276 €, p = 0.01). The number of days lost due to cardiovascular rehospitalizations in the intervention group (0.33 ± 0.15) was significantly lower than in the control group (0.79 ± 0.20) (p = 0.037). Conclusions This paper shows that overall, the addition of the telerehabilitation program to centre-based CR was cost-saving by reducing cardiovascular rehospitalisation rate. These results are useful for policy makers charged with deciding how limited health care resources should best be allocated in the era of exploding need.