Cost-utility analysis and impact on the environment of videoconference in pressure injury. A randomized controlled trial in individuals with spinal cord injury

Spinal Cord Series and Cases, 2024 · DOI: https://doi.org/10.1038/s41394-024-00621-w · Published: February 26, 2024

Spinal Cord Injury Healthcare Telehealth & Digital Health

Simple Explanation

This study compared the cost and health outcomes of treating pressure injuries in people with spinal cord injury using regular care versus regular care with additional videoconference consultations. The study found that videoconferencing cost more but did not significantly improve quality of life. The study also looked at the environmental impact of transportation and found no significant differences between the two groups.

Study Duration

1 year

Participants

56 participants with spinal cord injury and ongoing pressure injury

Evidence Level

Level 1: Prospective randomized controlled trial

Key Findings

1
The videoconference group (VCG) cost €5212 more for an additional 0.1 QALYs, resulting in an ICER of €52,120 per QALY.
2
No significant differences were identified regarding HRQoL or secondary outcomes.
3
No significant differences were found regarding transportation-related costs, or emission of greenhouse gases.

Research Summary

The study explores the potential health outcomes and associated costs of introducing videoconference consultations in addition to regular care (VCG) when compared to regular care alone (RCG). During the 1-year follow-up, virtually no difference in health-related quality of life was observed between the two groups. The cost-utility analysis demonstrated that VCG was more costly compared to RCG, with € 52,120 per QALYs gained.

Practical Implications

Clinical Practice

The study suggests that using videoconferencing in addition to regular care may not be cost-effective for treating pressure injuries in individuals with spinal cord injury.

Environmental Impact

The study indicates that there's no significant difference in environmental impact (transportation costs or greenhouse gas emissions) between videoconferencing and regular care.

Future Research

Further research could explore alternative telemedicine models or focus on specific subgroups of patients who might benefit more from videoconferencing.

Study Limitations

1
Three participants were excluded from the HRQoL analyses, due to lack of information at baseline and end-of follow-up, thus a modiﬁed intention-to-treat analysis was performed.
2
It was not possible to compare videoconference consultations only to on-site consultations only, due to ethical and clinical considera- tions, as well as the choices made by participants regarding their follow-up.
3
The low number of participants in the study makes it difﬁcult to generalize the results to the total population, even though the number was not limited by strict inclusion and exclusion criteria.

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