Cost-Effectiveness of Digital Prehabilitation

Digital prehabilitation leverages technology such as mobile apps, telemedicine, and wearables to deliver personalized preoperative programs, which contributes to its cost-effectiveness by minimizing resource-intensive elements like in-person visits, dedicated facilities, and extensive staffing. Key factors driving these savings include reduced hospital lengths of stay (LOS), lower complication rates, decreased readmissions, and diminished travel expenses for patients and providers. For instance, in a study of patients undergoing total knee arthroplasty, digital prehabilitation via a mobile app resulted in an average cost saving of $2,217 AUD per patient, primarily through a shorter inpatient LOS (4.3 days vs. 5.0 days) and total LOS (7.6 days vs. 11.9 days). Broader systematic reviews on telerehabilitation—a closely related modality—report mean cost savings ranging from $1,200 to $6,500 per patient, with incremental cost-effectiveness ratios (ICERs) around $22,500 per quality-adjusted life year (QALY) gained, and a 90% probability of cost-effectiveness at a willingness-to-pay threshold of $30,000 per QALY. These efficiencies stem from scalable monitoring, where one healthcare professional can oversee multiple patients simultaneously via digital platforms, reducing the need for individualized clinician time and infrastructure. Additionally, digital approaches can prevent surgical cancellations and optimize resource allocation in strained healthcare systems, further enhancing economic viability without compromising patient outcomes like emotional well-being or functional capacity. However, while promising, evidence on long-term cost impacts remains limited, with some analyses noting methodological variability and the need for standardized evaluations.

Comparison with Traditional Prehabilitation

Traditional prehabilitation typically involves in-person sessions—often 1–3 times per week—with exercise, nutrition, and psychological support delivered through clinics or hospitals, which incurs higher costs due to facility usage, travel, and dedicated health coaches or clinicians. In contrast, digital prehabilitation is generally more cost-effective, with reports indicating it can be up to 84% cheaper by eliminating these elements and shifting to remote, app-based delivery that maintains or improves adherence through daily reminders and real-time tracking. For example, telerehabilitation after total hip replacement showed similar clinical effects but with cost savings of approximately 50% in some studies, including reduced session costs (e.g., $80.99 vs. $93.08 per session) and a significant decrease in patient time burden (4.21 fewer hours on average), particularly for those living farther from care centers. Traditional methods may cost around $100 USD for just 1–2 sessions, while digital alternatives achieve comparable or better outcomes—like reduced LOS and complications—at a fraction of the price, with ICERs often negative (indicating cost savings) when including societal perspectives like travel and productivity losses. However, traditional prehabilitation can still be cost-effective compared to no prehab at all, with about 64% of economic evaluations showing benefits over usual care, though it lacks the scalability of digital formats. Challenges for digital include initial tech setup costs and potential digital literacy barriers, but overall, it offers greater accessibility and efficiency, especially in resource-limited settings, with probabilities of cost-effectiveness reaching 98% at certain thresholds.