{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:06:04Z","timestamp":1770739564963,"version":"3.49.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R03 HS025043-01A1"],"award-info":[{"award-number":["R03 HS025043-01A1"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Context<\/jats:title>\n<jats:p>Aphasia is a post-stroke condition that can dramatically impact a person with aphasia\u2019s (PWA) communication abilities. To date, few if any studies have considered the cost and cost-effectiveness of functional change in aphasia nor considered measures of patient\u2019s value for aphasia treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To assess the cost, cost-effectiveness, and perceived value associated with improved functional communication in individuals receiving telerehabilitation treatment for aphasia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Design<\/jats:title>\n<jats:p>Twenty PWA completed between 5 and 12 telehealth rehabilitation sessions of 45\u201360 minutes within a 6-week time frame using a Language-Oriented Treatment (LOT) designed to address a range of language issues among individuals with aphasia. National Outcomes Measures (NOMS) comprehension and verbal expression and the ASHA Quality of Communication Life (QCL) were completed prior to and at the completion of rehabilitation to obtain baseline and treatment measures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Age, education, and race are significantly correlated with improvement in the NOMS verbal expression. African Americans (OR = 2.0917) are twice as likely as Whites to experience improvement after treatment. The likelihood of improvement also increases with each additional year of education (OR = 1.002) but decrease with age (OR = 0.9463). A total of 15 PWA showed improvement in NOMS comprehension and nine patients showed improvement in NOMS verbal expression. Improving patients attended between five and 12 treatment sessions. The average cost of improvement in NOMS comprehension was $1,152 per patient and NOMS verbal expression was $1,128 per patient with individual treatment costs varying between $540 and $1,296. However, on average, the monetary equivalent in patient\u2019s improved QCL was between $1,790.39 to $3,912,54\u2014far exceeding the financial cost of treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>When measuring the functional improvement of patients with aphasia, patient\u2019s quality of communication life received from treatment exceeded financial cost of services provided.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0257462","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T17:33:08Z","timestamp":1631899988000},"page":"e0257462","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5943-8507","authenticated-orcid":true,"given":"Molly","family":"Jacobs","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Ellis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"pone.0257462.ref001","unstructured":"American Speech-Language Hearing Association. 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State of Aphasia Report\u2014Aphasia Access, https:\/\/www.aphasiaaccess.org\/white-papers\/ (2018, accessed 7 October 2020)."},{"key":"pone.0257462.ref004","article-title":"Mild aphasia: Is this the place for an argument?","author":"E Armstrong","journal-title":"Am J Speech-Language Pathol"},{"key":"pone.0257462.ref005","article-title":"Communication activity in stroke patients with aphasia","author":"JM Mazaux","journal-title":"J Rehabil Med"},{"key":"pone.0257462.ref006","article-title":"An investigation into the social participation of stroke survivors with aphasia","author":"RJP Dalemans","journal-title":"Disabil Rehabil"},{"key":"pone.0257462.ref007","article-title":"Effect of dysphasia and dysphagia on inpatient mortality and hospital length of stay: A database study","author":"V Guyomard","journal-title":"J Am Geriatr Soc"},{"key":"pone.0257462.ref008","article-title":"The one-year attributable cost of poststroke aphasia","author":"C Ellis","journal-title":"Stroke"},{"key":"pone.0257462.ref009","first-page":"111","article-title":"Patient protection and affordable care act","author":"P Protection","year":"2010","journal-title":"Public Law"},{"key":"pone.0257462.ref010","article-title":"Computer therapy compared with usual care for people with long-standing aphasia poststroke: A pilot randomized controlled trial","author":"R Palmer","journal-title":"Stroke"},{"key":"pone.0257462.ref011","article-title":"Feasibility and cost analysis of implementing high intensity aphasia clinics within a sub-acute setting","author":"R Wenke","year":"2014","journal-title":"International Journal of Speech-Language Pathology"},{"key":"pone.0257462.ref012","article-title":"Marginal assessment of the cost and benefits of aphasia treatment: Evidence from community-based telerehabilitation treatment for aphasia","author":"M Jacobs","year":"2021","journal-title":"Journal of Telemedicine and Telecare"},{"key":"pone.0257462.ref013","volume-title":"Western Aphasia Battery\u2013Revised","author":"A Kertesz","year":"2007"},{"issue":"26","key":"pone.0257462.ref014","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1056\/NEJMp1011024","article-title":"What is value in health care?","volume":"363","author":"M. E Porter","year":"2010","journal-title":"The New England journal of medicine"},{"issue":"4","key":"pone.0257462.ref015","doi-asserted-by":"crossref","first-page":"276","DOI":"10.18043\/ncm.77.4.276","article-title":"Measuring value in health care the times, They are a changin\u2019","volume":"77","author":"SE Wegner","year":"2016","journal-title":"North Carolina Medical Journal"},{"key":"pone.0257462.ref016","unstructured":"American Speech-Language-Hearing Association, National Outcomes Measurement System (NOMS). 2021. https:\/\/www.asha.org\/noms\/."},{"key":"pone.0257462.ref017","volume-title":"Quality of Communication Life Scale (ASHA QCL)","author":"D.R. 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