title: Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project.
abstract: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR) program. The aim of the intervention was to increase the patients' participation in the CTR program. At discharge, an individualized 3-month rehabilitation plan was formulated for each patient. At home, the patients measured their own blood pressure, pulse, weight, and steps taken for 3 months.
  
  
  
  The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form Health Survey.
  
  
  
  The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was €1,700 higher in the intervention group. The quality-adjusted life-years (QALYs) gain was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than €400,000 per QALY gained.
  
  
  
  Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself was not costly (less than €500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.
authors.affiliation: 1 Center for Innovative Medical Technology, Odense University Hospital , Odense, Denmark .
authors.forename: Kristian
authors.initials: K
authors.lastname: Kidholm
authors.affiliation: 1 Center for Innovative Medical Technology, Odense University Hospital , Odense, Denmark .
authors.forename: Maja Kjær
authors.initials: MK
authors.lastname: Rasmussen
authors.affiliation: 2 Department of Cardiothoracic Surgery, Aalborg University Hospital , Aalborg, Denmark .|3 Department of Clinical Medicine, Aalborg University , Aalborg, Denmark .
authors.forename: Jan Jesper
authors.initials: JJ
authors.lastname: Andreasen
authors.affiliation: 4 Laboratory for Cardio-Technology, Medical Informatics Group, Department of Health Science and Technology, Faculty of Medicine, Aalborg University , Aalborg, Denmark .
authors.forename: John
authors.initials: J
authors.lastname: Hansen
authors.affiliation: 5 Department of Cardiology, Vendsyssel Hospital , Hjoerring, Denmark .
authors.forename: Gitte
authors.initials: G
authors.lastname: Nielsen
authors.affiliation: 6 Department of Psychology and Behavioral Sciences, Aarhus Graduate School of Business and Social Sciences, Aarhus University , Aarhus, Denmark .
authors.forename: Helle
authors.initials: H
authors.lastname: Spindler
authors.affiliation: 7 Telehealth and Telerehabilitation, Laboratory of Assistive Technologies, SMI ®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University , Aalborg, Denmark .
authors.forename: Birthe
authors.initials: B
authors.lastname: Dinesen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001835:Body Weight; D000072038:Cardiac Rehabilitation / Q000191:economics* / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011674:Pulse; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D058998:Remote Sensing Technology; D000069350:Telerehabilitation / Q000191:economics* / Q000706:statistics & numerical data*
keywords: cost-utility; economic evaluation; heart patients; randomized study; telerehabilitation