Determining the Marginal Cost Differences of a Telehealth Versus an In-person Occupational Therapy Evaluation Session for Stroke Survivors Using Time-driven Activity-based Costing.

The reported observation was of 19 neuro-telerehabilitation sessions; the paper does not state how many outpatient sessions were observed. The model included patients with stroke and other neurological conditions, and the authors state results may not generalize to other conditions. Therapists interviewed were local to South Carolina, and wages used national averages, so local salaries, staffing, and reimbursement may differ. The study estimated care delivery time and cost, not clinical content, patient outcomes, or treatment effectiveness. Overhead, parking, hotel, mileage, missed visits, and technical difficulties were excluded from the main flowchart, although technical problems were tested in sensitivity analysis. The analysis used assumed full-time hours, fringe benefits, and productivity standards, so the cost figures depend on those assumptions.

The authors reported no conflicts of interest.

Do not conclude that telerehabilitation is always more expensive or that outpatient therapy is cheaper for every clinic. This estimate came from 19 observed telerehabilitation sessions and interview-based outpatient flowcharts, used national wage assumptions, and did not include overhead or patient outcomes.