NORCE Norwegian Research Centre AS, Nygårdsgaten 112, 5008 Bergen, Norway.
Hammel Neurocenter, Department of Clinical Medicine, Aarhus University, 8450 Hammel, Denmark.
Int J Technol Assess Health Care. 2019;35(5):373-378. doi: 10.1017/S026646231900059X. Epub 2019 Aug 27.
Stroke is a major cause of lasting disability worldwide. Virtual reality (VR) training has been introduced as a means of increasing the effectiveness of rehabilitation by providing large doses of task-related training with many repetitions and different modes of feedback. As VR is increasingly used in neurorehabilitation, cost considerations are important.
A cost-analysis was conducted based on the Virtual Reality for Upper Extremity in Subacute stroke (VIRTUES) trial, a recent international randomized controlled observer-blind multicenter trial. Average therapist time required per therapy session may differ between VR and conventional training (CT), leading to potential cost savings due to a therapist being able to supervise more than one patient at a time. Exploratory cost analyses are presented to explore such assumptions.
Based on our calculations, VR incurs extra costs as compared with CT when the same amount of therapist contact is provided, as was the case in VIRTUES. However, the exploratory analyses demonstrated that these costs may be rapidly counterbalanced when time for therapist supervision can be reduced.
Extra costs for VR can be outweighed by reduced therapist time and decreasing VR system costs in the nearer future, and not least by increased patient motivation.
脑卒中是全球范围内导致长期残疾的主要原因。虚拟现实(VR)训练已被引入,作为一种增加康复效果的手段,通过提供大量与任务相关的训练,具有多次重复和不同的反馈模式。随着 VR 在神经康复中的应用越来越多,成本考虑变得尤为重要。
本研究基于最近一项国际性、随机对照、观察者盲法、多中心的试验——虚拟现实上肢治疗亚急性期脑卒中(VIRTUES),进行了一项成本分析。每次治疗的平均治疗师所需时间可能因 VR 和常规训练(CT)而异,这使得治疗师能够同时监督多名患者,从而有可能节省成本。本文提出了探索性成本分析来探讨这些假设。
根据我们的计算,在 VIRTUES 中提供相同数量的治疗师接触时,与 CT 相比,VR 会产生额外的成本。然而,探索性分析表明,当治疗师的监督时间可以减少时,这些成本可能会迅速得到平衡。
在不久的将来,随着治疗师时间的减少和 VR 系统成本的降低,以及患者积极性的提高,VR 的额外成本可能会被抵消。