Cost and carbon footprint comparison of mobile pulmonary rehabilitation (m-PR) and centre-based pulmonary rehabilitation

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Background: The economic and environmental impacts of mobile health (mHealth) pulmonary rehabilitation (PR) should be evaluated to guide implementation. Aim: To determine the resource usage costs and greenhouse gas (GHG) emissions associated with mHealth PR (m-PR) when compared to centre-based PR (CB-PR) in people with COPD. Methods: Resource usage costs and GHG emissions analyses alongside a randomised controlled equivalence trial. Participants with COPD were randomised to eight weeks of m-PR or CB-PR. Resource usage costs from a societal perspective in 2024 Australian dollars ($), and Scope 1, 2 and 3 GHG emissions measured in kilograms of carbon dioxide equivalent (kgCO2e), were collected over the eight-week intervention period for each participant. A base-analysis, which considered resource usage costs and GHG emissions in research conditions, and a scenario analysis, which considered m-PR and CB-PR programs implemented within clinical practice in Sydney, Australia, were performed. Results: 90 participants were randomised (mean ± SD: age 75 ± 7 years, FEV1 57 ± 14% predicted), with 38 m-PR and 42 CB-PR participants included in the base analysis. From the base analysis, there were no between group differences in per-participant costs (MD $21, 95% CI -$46 to $88) or GHG emissions (MD -21kgCO2e, 95% CI -51 kgCO2e to 8 kgCO2e). From the scenario analysis, m-PR resulted in a cost-saving of $144 (95% CI $91 to $197) and a GHG emissions-saving of 36 kgCO2e (95% CI 8 kgCO2e to 63 kgCO2e) per participant when compared to CB-PR. Conclusion: mHealth PR is associated with lower resource usage costs and GHG emissions when compared to centre-based PR for people with COPD.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.