Real-world provider-level costs of multidisciplinary telerehabilitation for neurological rehabilitation: A comparative cost analysis.

IntroductionTelerehabilitation has emerged as a promising strategy for improving access to neurological rehabilitation while addressing increasing healthcare demands and resource constraints. Although evidence supporting its clinical effectiveness has expanded considerably, information regarding its economic implications and potential relevance for reimbursement policy and healthcare planning remains limited. This study aimed to compare the costs of a multidisciplinary telerehabilitation programme with those of conventional facility-based neurological rehabilitation and to estimate the potential budgetary consequences of large-scale implementation.MethodsA retrospective comparative cost analysis and budget impact assessment was conducted using prospectively collected programme data and hospital accounting records. The study included 243 individuals receiving telerehabilitation for stroke-related hemiplegia (n = 90), Parkinson's disease (n = 61), aphasia (n = 60), and cerebral palsy (n = 32). Conventional rehabilitation consisted of routine face-to-face multidisciplinary neurological rehabilitation delivered within the same healthcare system using comparable treatment intensity, and costs were derived from real-world institutional expenditure records. Costs were analysed from the health system/provider perspective and standardized to a 30-session rehabilitation episode. Cost outcomes included cost per session, cost per patient, absolute cost difference, relative cost reduction, and cost ratio. A simplified budget impact projection was performed to estimate projected expenditures and savings for hypothetical patient populations ranging from 1000 to 50,000 individuals.ResultsThe mean cost per rehabilitation session was United States Dollars (USD) 365.91 for conventional rehabilitation and USD 164.66 for telerehabilitation. The corresponding cost per patient for a standardized 30-session rehabilitation episode was USD 10,977.43 and USD 4939.84, respectively. Telerehabilitation reduced provider-level costs by USD 6037.59 per patient, corresponding to a relative cost reduction of 55.0%, meaning that telerehabilitation required only 45.0% of the provider cost of an equivalent episode of conventional rehabilitation. Budget impact projections demonstrated potential savings of approximately USD 6.0 million for 1000 patients, increasing to USD 301.9 million for 50,000 patients.ConclusionsIn this real-world provider-level economic analysis, multidisciplinary telerehabilitation was associated with substantially lower provider-level costs than conventional facility-based neurological rehabilitation. The observed cost reduction was primarily attributable to differences in infrastructure and operational resource utilization between service delivery models. If comparable clinical outcomes can be maintained, telerehabilitation may represent a financially sustainable strategy for expanding rehabilitation capacity while supporting efficient resource allocation. However, because comparative clinical effectiveness was not evaluated, the findings should be interpreted as evidence of potential cost savings rather than cost-effectiveness. These findings may provide valuable evidence for reimbursement policy development, healthcare planning, and long-term resource allocation.