Cost effectiveness of gym and home-based exercise programs adults with chronic conditions

PhD candidate  Paul Jansons1,2, Dr Lisa  O’Brien2,3, PhD candidate  Lauren  Robins1,2, Prof Terry Haines1,2

1Monash Health, Allied Health Research Unit, Cheltenham, Australia, 2Monash University, Physiotherapy Department, Frankston, Australia, 3Monash University, Occupational Therapy Department, Frankston, Australia

 

Aim

To investigate the comparative cost effectiveness of gym versus home-based exercise programs with telephone-follow up for adults with chronic health conditions who had completed a short term, supervised exercise program

Method

A two-group 12 month intervention, randomised controlled trial. One group received a gym based exercise program, the other a home-based exercise program with telephone follow up. The economic evaluation took the form of a trial-based, comparative, incremental cost-utility analysis undertaken from the societal perspective with a 12 month time horizon. Health care costs were collected from government databases and participant self-report, productivity costs from self-report, and health utility was measured using the EQ-5D-3L

Results

100 participants included in the dataset. The gym-based follow-up approach would cost an additional $491,572 AUD from the societal perspective to gain one quality adjusted life year compared to the telephone-based approach. There was considerable uncertainty in this finding in that there was a 37% probability that the telephone-based approach was both less costly and more effective than they gym-based approach. Sensitivity analyses were conducted to vary the perspective of the evaluation to both the patient and health service perspectives separately.

Significance of the findings to allied health

The gym-based approach was more costly to implement. These additional costs are unlikely to be justified by differences in health outcomes attained. Further research conducted across multiple socioeconomic groups and with an additional no-intervention comparison group is warranted to further inform clinical decision-making in this area