An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke

Todd H. Wagner, Albert C. Lo, Peter Peduzzi, Dawn Bravata, Grant D. Huang, Hermano I. Krebs, Robert J. Ringer, Daniel G. Federman, Lorie G. Richards, Jodie K. Haselkorn, George F. Wittenberg, Bruce T. Volpe, Christopher T. Bever, Pamela W. Duncan, Andrew Siroka, Peter D. Guarino

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Background and Purpose-Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness. Methods-We estimated the intervention costs and tracked participants healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization. Results-A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (P<0.001), and both were significantly more expensive than usual care alone (no additional intervention costs). At 36 weeks postrandomization, the total costs were comparable for the 3 groups ($17 831 for robot therapy, $19 746 for intensive comparison therapy, and $19 098 for usual care). Changes in quality of life were modest and not statistically different. Conclusions-The added cost of delivering robot or intensive comparison therapy was recuperated by lower healthcare use costs compared with those in the usual care group. However, uncertainty remains about the cost-effectiveness of robotic-assisted rehabilitation compared with traditional rehabilitation.

Original languageEnglish
Pages (from-to)2630-2632
Number of pages3
JournalStroke
Volume42
Issue number9
DOIs
StatePublished - Sep 2011

Fingerprint

Upper Extremity
Stroke
Economics
Costs and Cost Analysis
Rehabilitation
Robotics
Therapeutics
Health Care Costs
Cost-Benefit Analysis
Quality of Life
Veterans
Critical Care
Random Allocation
Uncertainty
Health

Keywords

  • cost
  • economic
  • rehabilitation
  • robotics
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Wagner, T. H., Lo, A. C., Peduzzi, P., Bravata, D., Huang, G. D., Krebs, H. I., ... Guarino, P. D. (2011). An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke. Stroke, 42(9), 2630-2632. https://doi.org/10.1161/STROKEAHA.110.606442

An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke. / Wagner, Todd H.; Lo, Albert C.; Peduzzi, Peter; Bravata, Dawn; Huang, Grant D.; Krebs, Hermano I.; Ringer, Robert J.; Federman, Daniel G.; Richards, Lorie G.; Haselkorn, Jodie K.; Wittenberg, George F.; Volpe, Bruce T.; Bever, Christopher T.; Duncan, Pamela W.; Siroka, Andrew; Guarino, Peter D.

In: Stroke, Vol. 42, No. 9, 09.2011, p. 2630-2632.

Research output: Contribution to journalArticle

Wagner, TH, Lo, AC, Peduzzi, P, Bravata, D, Huang, GD, Krebs, HI, Ringer, RJ, Federman, DG, Richards, LG, Haselkorn, JK, Wittenberg, GF, Volpe, BT, Bever, CT, Duncan, PW, Siroka, A & Guarino, PD 2011, 'An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke', Stroke, vol. 42, no. 9, pp. 2630-2632. https://doi.org/10.1161/STROKEAHA.110.606442
Wagner, Todd H. ; Lo, Albert C. ; Peduzzi, Peter ; Bravata, Dawn ; Huang, Grant D. ; Krebs, Hermano I. ; Ringer, Robert J. ; Federman, Daniel G. ; Richards, Lorie G. ; Haselkorn, Jodie K. ; Wittenberg, George F. ; Volpe, Bruce T. ; Bever, Christopher T. ; Duncan, Pamela W. ; Siroka, Andrew ; Guarino, Peter D. / An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke. In: Stroke. 2011 ; Vol. 42, No. 9. pp. 2630-2632.
@article{20b474581cc2463a875a79d10875bdf5,
title = "An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke",
abstract = "Background and Purpose-Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness. Methods-We estimated the intervention costs and tracked participants healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization. Results-A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (P<0.001), and both were significantly more expensive than usual care alone (no additional intervention costs). At 36 weeks postrandomization, the total costs were comparable for the 3 groups ($17 831 for robot therapy, $19 746 for intensive comparison therapy, and $19 098 for usual care). Changes in quality of life were modest and not statistically different. Conclusions-The added cost of delivering robot or intensive comparison therapy was recuperated by lower healthcare use costs compared with those in the usual care group. However, uncertainty remains about the cost-effectiveness of robotic-assisted rehabilitation compared with traditional rehabilitation.",
keywords = "cost, economic, rehabilitation, robotics, stroke",
author = "Wagner, {Todd H.} and Lo, {Albert C.} and Peter Peduzzi and Dawn Bravata and Huang, {Grant D.} and Krebs, {Hermano I.} and Ringer, {Robert J.} and Federman, {Daniel G.} and Richards, {Lorie G.} and Haselkorn, {Jodie K.} and Wittenberg, {George F.} and Volpe, {Bruce T.} and Bever, {Christopher T.} and Duncan, {Pamela W.} and Andrew Siroka and Guarino, {Peter D.}",
year = "2011",
month = "9",
doi = "10.1161/STROKEAHA.110.606442",
language = "English",
volume = "42",
pages = "2630--2632",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke

AU - Wagner, Todd H.

AU - Lo, Albert C.

AU - Peduzzi, Peter

AU - Bravata, Dawn

AU - Huang, Grant D.

AU - Krebs, Hermano I.

AU - Ringer, Robert J.

AU - Federman, Daniel G.

AU - Richards, Lorie G.

AU - Haselkorn, Jodie K.

AU - Wittenberg, George F.

AU - Volpe, Bruce T.

AU - Bever, Christopher T.

AU - Duncan, Pamela W.

AU - Siroka, Andrew

AU - Guarino, Peter D.

PY - 2011/9

Y1 - 2011/9

N2 - Background and Purpose-Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness. Methods-We estimated the intervention costs and tracked participants healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization. Results-A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (P<0.001), and both were significantly more expensive than usual care alone (no additional intervention costs). At 36 weeks postrandomization, the total costs were comparable for the 3 groups ($17 831 for robot therapy, $19 746 for intensive comparison therapy, and $19 098 for usual care). Changes in quality of life were modest and not statistically different. Conclusions-The added cost of delivering robot or intensive comparison therapy was recuperated by lower healthcare use costs compared with those in the usual care group. However, uncertainty remains about the cost-effectiveness of robotic-assisted rehabilitation compared with traditional rehabilitation.

AB - Background and Purpose-Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness. Methods-We estimated the intervention costs and tracked participants healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization. Results-A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (P<0.001), and both were significantly more expensive than usual care alone (no additional intervention costs). At 36 weeks postrandomization, the total costs were comparable for the 3 groups ($17 831 for robot therapy, $19 746 for intensive comparison therapy, and $19 098 for usual care). Changes in quality of life were modest and not statistically different. Conclusions-The added cost of delivering robot or intensive comparison therapy was recuperated by lower healthcare use costs compared with those in the usual care group. However, uncertainty remains about the cost-effectiveness of robotic-assisted rehabilitation compared with traditional rehabilitation.

KW - cost

KW - economic

KW - rehabilitation

KW - robotics

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=80052395512&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052395512&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.110.606442

DO - 10.1161/STROKEAHA.110.606442

M3 - Article

C2 - 21757677

AN - SCOPUS:80052395512

VL - 42

SP - 2630

EP - 2632

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 9

ER -