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Meeting Unmet Needs for Stroke Rehabilitation in Rural Public Health: Explorative Economic Evaluation of Upper Limb Robotics-Based Technologies through a Capabilities Lens

Author

Listed:
  • Natasha Brusco

    (Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne 3199, Australia)

  • Andrea Voogt

    (Department of Allied Health & Community Services, Northeast Health Wangaratta, Wangaratta 3747, Australia)

  • Melissa Nott

    (Three Rivers Department of Rural Health, Charles Sturt University, Wagga Wagga 2640, Australia)

  • Libby Callaway

    (Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne 3199, Australia
    Occupational Therapy Department, Monash University, Melbourne 3199, Australia)

  • Mae Mansoubi

    (Digital Health Innovation and Public Health, INTERSECT, Medical School, University of Exeter, Exeter EX1 2LU, UK)

  • Natasha Layton

    (Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne 3199, Australia)

Abstract

Rehabilitation technologies are rapidly evolving, presenting promising interventions for people with neurological impairments. Access to technology, however, is greater in metropolitan than rural areas. Applying a capabilities approach to this access issue foregrounds healthcare recipients’ rights and personhood within the discourse on resource allocation. Within this context, this study aimed to investigate the economic viability of robotics-based therapy (RBT) in rural Victoria, Australia. A regional health network developed a model of care to provide equitable access to RBT following stroke. This explorative economic evaluation examined both the clinical and economic impact of RBT program implementation across six program iterations compared to 1:1 out-patient rehabilitation. While clinical outcomes were equivalent, the per patient RBT cost ranged from AUD 2681 (Program 1) to AUD 1957 (Program 6), while the per patient cost of usual care 1:1 out-patient rehabilitation, was AUD 2584. Excluding Program 1, the health service cost of usual care 1:1 out-patient rehabilitation was consistently higher, indicating that an established RBT program may be cost-effective, specifically providing less cost for the same effect. This research demonstrates the economic feasibility of delivering RBT in a regional public health stroke service. More broadly, it provided a reduction in the capability gap between rural and metropolitan stroke survivors by tackling an access disadvantage.

Suggested Citation

  • Natasha Brusco & Andrea Voogt & Melissa Nott & Libby Callaway & Mae Mansoubi & Natasha Layton, 2022. "Meeting Unmet Needs for Stroke Rehabilitation in Rural Public Health: Explorative Economic Evaluation of Upper Limb Robotics-Based Technologies through a Capabilities Lens," Societies, MDPI, vol. 12(5), pages 1-20, October.
    • Handle: RePEc:gam:jsoctx:v:12:y:2022:i:5:p:143-:d:937637
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. David A. Clark & University of Manchester, 2005. "The Capability Approach: Its Development, Critiques and Recent Advances," Economics Series Working Papers GPRG-WPS-032, University of Oxford, Department of Economics.
    3. Frances Stewart, 2013. "Nussbaum on the Capabilities Approach," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 14(1), pages 156-160, February.
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    Cited by:

    1. Natasha Layton & Silvana Contepomi & Maria del Valle Bertoni & Maria Helena Martinez Oliver, 2022. "When the Wheelchair Is Not Enough: What Capabilities Approaches Offer Assistive Technology Practice in Rural Argentina," Societies, MDPI, vol. 12(6), pages 1-12, November.
    2. Natasha Layton & Johan Borg, 2023. "Assistive Technology and the Wellbeing of Societies from a Capabilities Approach," Societies, MDPI, vol. 13(2), pages 1-3, January.

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