Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial

Br J Anaesth. 2017 Nov 1;119(5):1039-1046. doi: 10.1093/bja/aex332.

Abstract

Background: Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphone-based application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on postoperative recovery compared with standard care.

Methods: This study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use.

Results: The mean cost for health-care consumption during 2 weeks after surgery was estimated at €37.29 for the intervention group and €60.96 for the control group. The mean difference was €23.66 (99% confidence interval -46.57 to - 0.76; P=0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of €4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P=0.75). The probability of the intervention being cost-effective was 71%.

Conclusions: This study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective tool in providing low-cost health-care contacts and in systematically assessing the quality of postoperative recovery.

Clinical trial registration: NCT02492191.

Keywords: ambulatory surgery; cost effectiveness; mobile applications; postoperative period.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Ambulatory Surgical Procedures / economics
  • Ambulatory Surgical Procedures / rehabilitation*
  • Cost-Benefit Analysis / economics*
  • Cost-Benefit Analysis / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mobile Applications / economics*
  • Postoperative Care / economics*
  • Postoperative Care / methods*
  • Prospective Studies
  • Single-Blind Method
  • Smartphone / economics*
  • Sweden
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT02492191