Effect of comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, medical costs and quality of life: A cost-effectiveness analysis

Eur J Prev Cardiol. 2016 May;23(7):674-82. doi: 10.1177/2047487315602257. Epub 2015 Aug 19.


Background: Notwithstanding the cardiovascular disease epidemic, current budgetary constraints do not allow for budget expansion of conventional cardiac rehabilitation programmes. Consequently, there is an increasing need for cost-effectiveness studies of alternative strategies such as telerehabilitation. The present study evaluated the cost-effectiveness of a comprehensive cardiac telerehabilitation programme.

Design and methods: This multi-centre randomized controlled trial comprised 140 cardiac rehabilitation patients, randomized (1:1) to a 24-week telerehabilitation programme in addition to conventional cardiac rehabilitation (intervention group) or to conventional cardiac rehabilitation alone (control group). The incremental cost-effectiveness ratio was calculated based on intervention and health care costs (incremental cost), and the differential incremental quality adjusted life years (QALYs) gained.

Results: The total average cost per patient was significantly lower in the intervention group (€2156 ± €126) than in the control group (€2720 ± €276) (p = 0.01) with an overall incremental cost of €-564.40. Dividing this incremental cost by the baseline adjusted differential incremental QALYs (0.026 QALYs) yielded an incremental cost-effectiveness ratio of €-21,707/QALY. The number of days lost due to cardiovascular rehospitalizations in the intervention group (0.33 ± 0.15) was significantly lower than in the control group (0.79 ± 0.20) (p = 0.037).

Conclusions: This paper shows the addition of cardiac telerehabilitation to conventional centre-based cardiac rehabilitation to be more effective and efficient than centre-based cardiac rehabilitation alone. These results are useful for policy makers charged with deciding how limited health care resources should best be allocated in the era of exploding need.

Keywords: Telerehabilitation; cost-effectiveness; telecoaching; telemonitoring.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiac Rehabilitation / economics*
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / therapy*
  • Cost-Benefit Analysis
  • Female
  • Follow-Up Studies
  • Health Care Costs / trends*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / economics
  • Patient Readmission / trends*
  • Prospective Studies
  • Quality of Life*
  • Quality-Adjusted Life Years*
  • Rehabilitation Centers
  • Telerehabilitation / economics*
  • Time Factors