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

• Published in: British journal of anaesthesia : BJA Vol. 119; no. 5; pp. 1039 - 1046
• Main Authors: Dahlberg, K., Philipsson, A., Hagberg, L., Jaensson, M., Hälleberg-Nyman, M., Nilsson, U.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2017; Oxford University Press
• Subjects: Ambulatory surgery; Ambulatory Surgical Procedures - economics; Ambulatory Surgical Procedures - rehabilitation; cost effectiveness; Cost-Benefit Analysis - economics; Cost-Benefit Analysis - statistics & numerical data; Female; Humans; Male; Medicin och hälsovetenskap; Middle Aged; mobile applications; Mobile Applications - economics; Postoperative Care - economics; Postoperative Care - methods; postoperative period; Prospective Studies; Single-Blind Method; Smartphone - economics; Sweden; Treatment Outcome; Sweden; postoperative period; cost effectiveness; mobile applications; ambulatory surgery
• ISSN: 0007-0912; 1471-6771; 1471-6771
• DOI: 10.1093/bja/aex332

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. 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. 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%. 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. NCT02492191.