Telehealth versus in-person delivery of an occupational therapy home visiting service: A cost analysis.

The study was not randomised. Allocation to telehealth or in-person care was based on clinical judgement and service availability, which introduces selection bias. The analysis did not capture costs to patients and caregivers, such as productivity impacts or indirect costs. Six patients in the telehealth group and one in the in-person group had no recorded activity in the last six months, so their costs were not included. The study did not assess patient or clinical preferences, so it is unclear if the cost savings came at the expense of patient satisfaction or perceived quality of care. The telehealth group included 'hybrid' patients who switched to in-person care, which may have influenced the cost outcomes, although sensitivity analysis suggested this did not change the overall conclusions.

The authors declared no conflicts of interest. The study was funded by the Sir Charles Gairdner Osborne Park Health Care Group.

Do not assume telehealth is universally cost-effective or safe for all home visit populations. While it saved money overall, it was associated with significantly higher costs for pressure injury events due to likely delayed detection and subsequent hospital admissions. This suggests telehealth may be inappropriate for patients with high risks of pressure injuries without strict escalation protocols.