K Peng1,2, M Yang3, M Tian2,4, M Chen5, J Zhang4,6, X Wu3, R Ivers1,2,6, L Si7. 1. School of Public Health, The University of Sydney, Sydney, Australia. 2. The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW, 2042, Australia. 3. Department of Orthopedic and Traumatology, Beijing Jishuitan Hospital, Beijing, China. 4. The George Institute for Global Health at Peking University Health Science Center, Beijing, China. 5. School of Health Policy & Management, Nanjing Medical University, Nanjing, China. 6. School of Public Health and Community Medicine, UNSW, Kensington, Australia. 7. The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW, 2042, Australia. lsi@georgeinstitute.org.au.
Abstract
The multidisciplinary co-management program for geriatric patients with hip fracture is cost-effective in the Chinese population and it has the potential to be scaled up in China. INTRODUCTION: The study aimed to investigate the cost-effectiveness of a multidisciplinary co-management program for patients with hip fracture in China. METHODS: Hip fracture patients who were admitted to an orthopedic hospital in Beijing were included in the multidisciplinary co-management program. The cost-effectiveness of intervention was evaluated compared to the conventional management. A Markov microsimulation model was developed to simulate lifetime costs and effectiveness. Costs including intervention, hospitalization, medications, and long-term care costs were expressed using 2019 US dollars and the healthcare perspective was adopted. Effectiveness was evaluated using both 1-year mortality-averted and quality-adjusted life years (QALYs). Costs and effectiveness were discounted at 5% per annum. The willingness-to-pay (WTP) threshold was set at $26,481 per QALY gained which was three times gross domestic product (GDP) per capita in China. One-way and probabilistic sensitivity analyses were conducted. RESULTS: The lifetime cost for the conventional management (n = 1839) and intervention group (n = 1192) was $11,975 and $13,309 respectively. The lifetime QALYs were 2.38 and 2.45 years and the first-year mortality was 17.8% and 16.1%. The incremental cost-effectiveness ratio was $19,437 per QALY gained or $78,412 per 1-year mortality-averted. Given the Chinese WTP threshold, the intervention had a 78% chance being cost-effective. The cost-effectiveness of the intervention was sensitive to cost of intervention and the proportion of patients who underwent surgery within 48 h. CONCLUSIONS: The multidisciplinary co-management program for patients with hip fracture is cost-effective and it has the potential to be scaled up in the Chinese population.
The multidisciplinary co-management program for geriatric patients with hip fracture is cost-effective in the Chinese population and it has the potential to be scaled up in China. INTRODUCTION: The study aimed to investigate the cost-effectiveness of a multidisciplinary co-management program for patients with hip fracture in China. METHODS:Hip fracturepatients who were admitted to an orthopedic hospital in Beijing were included in the multidisciplinary co-management program. The cost-effectiveness of intervention was evaluated compared to the conventional management. A Markov microsimulation model was developed to simulate lifetime costs and effectiveness. Costs including intervention, hospitalization, medications, and long-term care costs were expressed using 2019 US dollars and the healthcare perspective was adopted. Effectiveness was evaluated using both 1-year mortality-averted and quality-adjusted life years (QALYs). Costs and effectiveness were discounted at 5% per annum. The willingness-to-pay (WTP) threshold was set at $26,481 per QALY gained which was three times gross domestic product (GDP) per capita in China. One-way and probabilistic sensitivity analyses were conducted. RESULTS: The lifetime cost for the conventional management (n = 1839) and intervention group (n = 1192) was $11,975 and $13,309 respectively. The lifetime QALYs were 2.38 and 2.45 years and the first-year mortality was 17.8% and 16.1%. The incremental cost-effectiveness ratio was $19,437 per QALY gained or $78,412 per 1-year mortality-averted. Given the Chinese WTP threshold, the intervention had a 78% chance being cost-effective. The cost-effectiveness of the intervention was sensitive to cost of intervention and the proportion of patients who underwent surgery within 48 h. CONCLUSIONS: The multidisciplinary co-management program for patients with hip fracture is cost-effective and it has the potential to be scaled up in the Chinese population.
Entities:
Keywords:
Cost-effectiveness analysis; Hip fracture; Multidisciplinary management; Older people
Authors: Nannan Li; Dennis Cornelissen; Stuart Silverman; Daniel Pinto; Lei Si; Ingrid Kremer; Sandrine Bours; Robin de Bot; Annelies Boonen; Silvia Evers; Joop van den Bergh; Jean-Yves Reginster; Mickaël Hiligsmann Journal: Pharmacoeconomics Date: 2020-10-07 Impact factor: 4.981