• K Dahlberg, A Philipsson, L Hagberg, M Jaensson, M Hälleberg-Nyman, and U Nilsson.
• School of Health Sciences, Faculty of Medicine and Health, Örebro University, 701 82 Örebro, Sweden.
• Br J Anaesth. 2017 Nov 1; 119 (5): 1039-1046.

BackgroundMost surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphone-based application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on postoperative recovery compared with standard care.MethodsThis study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use.ResultsThe mean cost for health-care consumption during 2 weeks after surgery was estimated at €37.29 for the intervention group and €60.96 for the control group. The mean difference was €23.66 (99% confidence interval -46.57 to - 0.76; P=0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of €4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P=0.75). The probability of the intervention being cost-effective was 71%.ConclusionsThis study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective tool in providing low-cost health-care contacts and in systematically assessing the quality of postoperative recovery.Clinical Trial RegistrationNCT02492191.© The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.

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