Budget impact analysis of robotic exoskeleton use for locomotor training following spinal cord injury in four SCI Model Systems

Journal of NeuroEngineering and Rehabilitation, 2020 · DOI: https://doi.org/10.1186/s12984-019-0639-0 · Published: January 1, 2020

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

This study estimates the financial impact of using robotic exoskeletons for walking training in spinal cord injury rehabilitation, compared to other methods. The analysis looks at how costs change when a robotic exoskeleton is used for 10% of locomotor training sessions. The study found that using robotic exoskeletons could lower hospital costs for locomotor training, but this depends on how often the device is used and other factors.

Study Duration

1 Year

Participants

Data from four Spinal Cord Injury (SCI) Model Systems rehabilitation hospitals

Evidence Level

Not specified

Key Findings

1
In the base case scenario, using robotic exoskeletons for over-ground training was associated with lower costs for locomotor training of people with SCI.
2
The cost savings are sensitive to factors like the cost of the exoskeleton, how often it's used, and what type of training it replaces.
3
Increasing conventional overground training by 10% resulted in greater savings than shifting market share to RT-exo.

Research Summary

The study evaluated the budget impact of integrating robotic exoskeletons into locomotor training for SCI rehabilitation across four SCI Model Systems, considering device costs, training costs, and human capital costs. The base case analysis suggested that robotic exoskeletons could decrease hospital costs associated with locomotor training, but these savings were sensitive to various parameters. Sensitivity analyses revealed that the model was more sensitive to clinical utilization parameters (e.g., device idle time) than device-specific parameters (e.g., device cost).

Practical Implications

Cost-effectiveness of Robotic Exoskeletons

Robotic exoskeletons may be a cost-effective addition to locomotor training if efficacy holds true and the technology is adopted within the health system.

Importance of Utilization Rate

The adoption rate and utilization of robotic exoskeletons significantly impact cost savings; strategies to increase device usage are crucial.

Comparison with Conventional Training

Increasing conventional overground training can yield greater cost savings than robotic exoskeleton training, highlighting the importance of considering various training modalities.

Study Limitations

1
The study did not account for differences in locomotor training effectiveness between alternatives.
2
There is limited data on the risks to users with SCI and personnel associated with locomotor training for RT-exo.
3
The retrospective study design provides estimates for the number of individuals with SCI who received locomotor training therapies in 2017.

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