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ORIGINAL RESEARCH article

Front. Public Health
Sec. Health Economics
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1445099

Cost analysis of technological versus conventional upper limb rehabilitation for patients with neurological disorders: an Italian real-world data case study

Provisionally accepted
Valerio Gower Valerio Gower 1*Irene Aprile Irene Aprile 1*Francesca Falchini Francesca Falchini 2Alessio Fasano Alessio Fasano 2Marco Germanotta Marco Germanotta 2Mattia Randazzo Mattia Randazzo 1Federico Spinelli Federico Spinelli 1Leopoldo Trieste Leopoldo Trieste 3Furio Gramatica Furio Gramatica 1Giuseppe Turchetti Giuseppe Turchetti 3
  • 1 IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
  • 2 IRCCS Don Carlo Gnocchi Firenze, Florence, Tuscany, Italy
  • 3 Istituto di Management, Scuola Sant'Anna di Studi Avanzati, Pisa, Tuscany, Italy

The final, formatted version of the article will be published soon.

    Most patients suffering from neurological disorders endure varying degrees of upper limb dysfunction, limiting their everyday activities, with only a limited number of those patients regaining full arm use. Robotic and technological rehabilitation has been demonstrated to be a feasible solution to guarantee an effective rehabilitation to recover upper limb performance or to prevent complications of upper limb immobility. However, there is currently a lack of studies which analyze the sustainability of robotic and technological rehabilitation by analyzing and comparing its costs to conventional rehabilitation pathways. Given that, technology-based and conventional rehabilitation of the upper limb have been demonstrated to have comparable efficacy when the rehabilitation dose is matched, our study concentrates on a cost minimization analysis. In particular, the aim of the research presented here is to compare the costs of an organizational model in which upper limb robotic rehabilitation is performed with a set of four devices, with conventional treatment. This has been done by developing a cost model and retrospectively analyzing the costs sustained by one of the hospitals of Fondazione Don Gnocchi which has adopted such an organizational model. The results show that robotic rehabilitation allowed the hospital to achieve savings compared to conventional treatments. A sensitivity analysis has been done to identify the parameters of the model that have the greatest influence on cost difference and to identify the conditions to optimize the efficiency of robotic rehabilitation. Finally, a probabilistic simulation approach has been applied to take into account the variability of model parameters and evaluate the probability of achieving a given level of savings.

    Keywords: cost analysis, robotic rehabilitation, Cost minimization, probabilistic simulation, sensitivity analysis

    Received: 06 Jun 2024; Accepted: 26 Sep 2024.

    Copyright: © 2024 Gower, Aprile, Falchini, Fasano, Germanotta, Randazzo, Spinelli, Trieste, Gramatica and Turchetti. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Valerio Gower, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
    Irene Aprile, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy

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