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远程康复干预与家庭护理对重度神经功能障碍成人患者的成本效益:一项随机临床试验。

Cost effectiveness of a telerehabilitation intervention vs home based care for adults with severe neurologic disability: A randomized clinical trial.

作者信息

Duruflé Aurélie, Le Meur Claire, Piette Patrice, Fraudet Bastien, Leblong Emilie, Gallien Philippe

机构信息

Rehabilitation Center, Pôle Saint Helier, Rennes, France.

出版信息

Digit Health. 2023 Aug 3;9:20552076231191001. doi: 10.1177/20552076231191001. eCollection 2023 Jan-Dec.

Abstract

CONTEXT

Several options are available for the care of neurological conditions including care delivered in rehabilitation centres, at home or remotely. While economic studies are available comparing centres and homes, very little economic data relates to mobile teams comparing face-to-face and remote care.

OBJECTIVE

To conduct an economic study comparing face-to-face care at home and care delivered remotely (tele-rehabilitation).

METHOD

A randomised clinical study with two groups; a control group receiving home care and an experimental group receiving tele-rehabilitation. The primary outcome measure was the ICER (Incremental Cost Effectiveness Ratio).

PARTICIPANTS

Patients with severe neurological disabilities.

RESULTS

80 patients were enrolled in the study; 77 were analysed to calculate the ICER, which was positive and located in the SW quadrant. A bootstrap with 1000 replications was positioned at 72.8% in the SW quadrant.

CONCLUSION

Tele-rehabilitation is an acceptable alternative to the management of neurological patients at home. In the mildest cases, remote-rehabilitation may even be dominant. More extensive studies are needed to specify the indications.

摘要

背景

神经疾病的护理有多种选择,包括在康复中心、家中或通过远程方式提供护理。虽然有经济研究比较了康复中心和家中护理,但很少有经济数据涉及移动团队比较面对面护理和远程护理的情况。

目的

进行一项经济研究,比较在家中进行的面对面护理和远程提供的护理(远程康复)。

方法

一项随机临床研究,分为两组;对照组接受家庭护理,实验组接受远程康复。主要结局指标是增量成本效益比(ICER)。

参与者

患有严重神经残疾的患者。

结果

80名患者纳入研究;77名患者进行分析以计算ICER,结果为阳性且位于西南象限。进行1000次重复的自抽样分析,结果显示位于西南象限的概率为72.8%。

结论

远程康复是在家中管理神经疾病患者的一种可接受的替代方案。在病情最轻的病例中,远程康复甚至可能更具优势。需要进行更广泛的研究以明确其适用情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6df9/10403989/4f7a8ccb482c/10.1177_20552076231191001-fig1.jpg

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