Cost comparison of a finnish web-based neuropsychological rehabilitation programme and traditional rehabilitation: A case study

Abstract

Background: The growing economic pressure on healthcare systems makes efficient resource allocation essential, while digital solutions can improve access to services. The Neuropsychological Digital Care Pathway (NP-DCP) is a professional-guided web-based rehabilitation programme for stroke patients with mild-to-moderate cognitive difficulties, aiming to respond to this pressure as an alternative to traditional face-to-face rehabilitation. Objectives: The aim of this study was to examine the cost structure of the NP-DCP to estimate its cost-efficiency for the health care provider. The second purpose was to assess organizational readiness in data availability, in order to suggest improvements required for rigorous economic evaluations in the future. Methods: In this mixed-method case study a cost-minimization analysis was the primary component, while qualitative interviews provided contextual understanding. Cost data was obtained retrospectively and complemented with a collected data sample to address missing information. Results: The estimated cost difference compared to traditional rehabilitation was 230 € per patient, leading to 23 000 € in annual savings with current NP-DCP patient volume. In this case, investment costs remained marginal, whereas the largest cost difference was clinician time per patient. Regarding data availability, suggestions to improve clinician time registering as well as costing model specificity and transparency were presented. Conclusions: The NP-DCP is a scalable and highly cost-efficient way to treat patients, as the effectiveness of the compared interventions can be considered roughly equivalent. This study lays the groundwork for subsequent research. With improved organizational data availability and robust evidence on clinical outcomes, a full cost-effectiveness analysis would be possible.