Economic Evaluation of Telerehabilitation: Systematic Literature Review of Cost-Utility Studies.

The review included only randomized controlled trial-based telerehabilitation studies that reported cost per quality-adjusted life year, so it does not cover all telerehabilitation models or cost-only studies. Many studies had small samples, and only 2 studies had more than 200 participants, so the cost-utility findings are uncertain. In more than half of the studies, the cost-utility result could not be concluded at a willingness-to-pay threshold. The studies were mostly from northern Europe, the United States, and Australia, so the results may not transfer to other health systems. Quality-adjusted life years may not capture all benefits of rehabilitation, especially for nonsevere conditions, where disease-specific measures may be more sensitive. Where blinding was not feasible, patient-reported quality-of-life outcomes could have been influenced by knowing the assigned treatment. Only 6 studies had a time horizon of 1 year or more, so longer-term costs and benefits were not well assessed.

The authors declared no conflicts of interest.

Do not conclude that telerehabilitation is proven cost-effective for every rehabilitation patient or that it can replace face-to-face care. The review included only randomized trial-based cost-utility studies, many had small samples, and more than half could not reach a firm cost-utility conclusion.