Tracy Comans1, Maree Raymer2, Shaun O'Leary3, David Smith4, Paul Scuffham5. 1. Senior Research Fellow, Centre for Applied Health Economics, Griffith Health Institute, Griffith University, Brisbane, Australia t.comans@griffith.edu.au. 2. Assistant Program Manager, Statewide Neurosurgical and Orthopaedic Physiotherapy Screening Clinic and Multi-disciplinary Service. Metro North Hospital and Health Service, Queensland, Australia. 3. Principal Research Fellow, Queensland Health (RBWH Physiotherapy Department/OPSC & MDS) and University of Queensland (NHMRC CCRE Spinal Pain, Injury and Health), Queensland, Australia. 4. Director of Physiotherapy Services and Program Manager, State wide Neurosurgical and Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service; West Moreton Hospital and Health Service, Queensland, Australia. 5. Professor of Health Economics and Director of the Population and Social Health Research Program, Centre for Applied Health Economics, Griffith Health Institute, Griffith University, Queensland, Australia.
Abstract
OBJECTIVE: Non-surgical treatment can be effective for many musculoskeletal conditions. Improving access to these options may improve the efficiency of hospitals. The Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service offers early comprehensive assessment and coordinated, patient-centred care within a multidisciplinary framework. Our aim was to assess its cost-effectiveness compared with usual orthopaedic care. METHODS: A Markov model was constructed to estimate the quality-adjusted life years and health care costs from the perspective of health care payers for outpatients with low back, knee or shoulder conditions compared to usual orthopaedic care. Data were obtained from a retrospective chart review, administrative sources, literature and expert opinion. The time frame was five years and all costs were reported in 2011 $AUD. RESULTS: Compared with usual orthopaedic care, the physiotherapist-led service costs an additional $495 per Quality Adjusted Life Year gained. The model remained cost-effective over a range of one-way sensitivity analyses. CONCLUSION: The physiotherapist-led service is likely to be highly cost-effective. Determining the optimal mix of hospital orthopaedic outpatient services may require more advanced modeling techniques to be applied.
OBJECTIVE: Non-surgical treatment can be effective for many musculoskeletal conditions. Improving access to these options may improve the efficiency of hospitals. The Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service offers early comprehensive assessment and coordinated, patient-centred care within a multidisciplinary framework. Our aim was to assess its cost-effectiveness compared with usual orthopaedic care. METHODS: A Markov model was constructed to estimate the quality-adjusted life years and health care costs from the perspective of health care payers for outpatients with low back, knee or shoulder conditions compared to usual orthopaedic care. Data were obtained from a retrospective chart review, administrative sources, literature and expert opinion. The time frame was five years and all costs were reported in 2011 $AUD. RESULTS: Compared with usual orthopaedic care, the physiotherapist-led service costs an additional $495 per Quality Adjusted Life Year gained. The model remained cost-effective over a range of one-way sensitivity analyses. CONCLUSION: The physiotherapist-led service is likely to be highly cost-effective. Determining the optimal mix of hospital orthopaedic outpatient services may require more advanced modeling techniques to be applied.
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