Economic Evaluation of Adult Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in a Variety of Settings

Are weekend inpatient rehabilitation services value for money? An economic evaluation alongside a randomized controlled trial with a 30 day follow up

“…If the willingness to pay in this study was AUD$50,000 per QALY gained or per MCID gained in functional independence, the probability of cost effectiveness in the intervention group approached 100%. Our results are consistent with a recent systematic review that reported a more intensive inpatient rehabilitation service can result in reduced cost to the health service, while improving patient outcomes [10]. …”

“…Studies are needed to investigate if the increased cost of a weekend rehabilitation service is offset by savings within the inpatient episode of care. Economic evaluations of additional weekday inpatient rehabilitation programs have shown a lower cost per patient admission [10-12], but it is not known if providing weekend rehabilitation services is cost effective, especially since factors such as weekend penalty rates for clinical staff may make provision of such a service more expensive. In the debate on whether to provide weekend health services, the issue of who will pay and whether providing such services is cost effective is central [1,2].…”

Systematic overview of economic evaluations of health-related rehabilitation

“…87 For example, in a methodologically rigorous SR, Brusco and colleagues concluded that ''a single rehabilitation service may not provide health economic benefits for all patient groups and situations.'' 21 The implicit acceptable thresholds for a cost-effectiveness ratio were reported to be $US 50,000 per QALY gained for the USA, £30,000 in the UK, and V80,000 for the Netherlands. 88 Authors of several SRs explicitly mentioned that the estimated cost-effectiveness ratios for some rehabilitation interventions were within the range of internationally acceptable cost-effectiveness ratio thresholds, or comparable with many conventional medical treatments.…”

“…Brusco et al (2014) 21 RCTs with economic evaluations High quality evidence (from 4 RCTs with 732 patients) indicated that inpatient rehabilitation was more costly than rehabilitation in the home, for patients with moderate to severe stroke and with an appropriate home environment and adequate social support. The health outcomes were similar or in favor of rehabilitation in the home.…”

“…21 It was reported that high quality evidence indicated that home-based rehabilitation was costsaving compared with inpatient rehabilitation for stroke survivors, with similar clinical outcomes. Home-based or community-based rehabilitation may also be less costly compared with inpatient rehabilitation in patients with orthopedic, rheumatoid arthritis, and age-related conditions.…”