Economic analysis of the use of a technological platform in the promotion of the health of adults and elderly people in Brazil

Abstract

PURPOSE: In the wake of the COVID-19 pandemic, the world has faced significant economic distress, as evidenced by billionaire losses, severe financial crises, medical inflation of 25%, and an 88% loss ratio (Soley-Bori et al, 2021). This period has also highlighted critical health issues, such as the dangers of a sedentary lifestyle (Katzmarzyk et al, 2012). Notably, in Brazil, falls are the third leading cause of death among elderly people, a concern that is projected to significantly exacerbate healthcare costs. To address these challenges, Techbalance introduced the Health Promotion and Disease Prevention Program (H.P.D.P.P.), a technological solution incorporating predictive analysis software to mitigate the risks of falls and injuries, supported by a data collection and processing application and a website for individual health management reports. This study aims to showcase the financial and health benefits of implementing the H.P.D.P.P. by Unimed Sul Paulista, analyzing its impact over a retrospective six-month period and a prospective year-long evaluation. METHOD: In 2022, Unimed Sul Paulista provided services to 36,144 beneficiaries, incorporating the TechBalance technology into its coordinated care management system. Two hundred beneficiaries were randomly selected from the 801 individuals actively participating in the program for a detailed study. The participants were divided into two groups: a control group (CG) and an intervention group (IG), each comprising 100 beneficiaries. Both groups underwent evaluations at the program's outset, but only the IG was reassessed after six months. The analysis over this six-month period focused on several key financial metrics: general expenses per beneficiary before and after the program's implementation, direct rehabilitation expenses for the IG compared to conventional physical therapy costs, and the financial implications of femoral neck fractures in the IG versus the CG. Additionally, the study projected the cost savings from avoided orthopedic surgeries within the program's first six months and compared the total cost of implementing the TechBalance program for all 801 participants against that of traditional care methods. Furthermore, an ROI (return on investment) was calculated for the 801 beneficiaries over a 12-month period postimplementation. This comprehensive study received approval from the Ethical Research Committee of UNIMED. RESULTS AND DISCUSSION: Over a six-month period, Unimed Sul Paulista's implementation of the TechBalance H.P.D.P.P. yielded notable improvements among participants:8% improved and 82% maintained their frailty levels, while 52% showed motor enhancements, primarily due to increased exercise-related strength, balance, and coordination. The program effectively reduced the prevalence of weight gain and dizziness, which are major factors in deterioration. A detailed analysis of health risks revealed a shift: the risk in the high-risk group marginally increased from 12.6% to 13%, that in the medium-risk group decreased significantly from 61.1% to 55%, and that in the low-risk group increased from 26.3% to 32%, suggesting that the intervention was particularly beneficial for those at medium and low risk. Economically, the intervention group experienced 71.31% cost reduction in areas such as accidents, rehabilitation, and orthopedic surgeries compared to the control group, with a projected return on investment (ROI) of 2.21 times the cost over 12 months for the 801 beneficiaries. This outcome not only demonstrates the financial viability of TechBalance's H.P.D.P.P. but, it also underscores the value of integrating technology with individual-centered care coordination, promoting physical activity, and embracing lifestyle medicine practices to enhance beneficiaries' quality of life and reduce healthcare costs (Pedersen & Saltin, 2015). The significant savings and positive health outcomes call for further research to validate these findings over a longer term and across the broader project population.

References

Soley-Bori, M; Ashworth, M.; Bisquera, A.; Dodhia,H.; Lynch, R.; Wang,Y; and  Fox-Rushby,J. (2021) Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature, British Journal of General Practice 2021; 71 (702): e39-e46. DOI: https://doi.org/10.3399/bjgp20X713897

Katzmarzyk PT, Lee I-M (2012). Sedentary behaviour and life expectancy in the USA: a cause-deleted life table    analysis. BMJ Open 2012;2: e000828. doi:10.1136/ bmjopen-2012-000828

Pedersen, B. K., & Saltin, B. (2015). Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian Journal of Medicine & Science in Sports, 25, 1-72. https://doi.org/10.1111/sms.12581

KEYWORDS : Digital Transformation, Health Promotion, Outcomes, Protocols, ROI

MAIN AFFILIATION AND COUNTRY OF FIRST AUTHOR

Affiliated Professor of the Discipline of Geriatrics and Gerontology, Paulista School of Medicine, Federal University of São Paulo, Brazil

CORRESPONDING AUTHOR EMAIL: dramaraiademello@gmail.com; Authors’ ORCID iDs: 0000-0001-9542-3134