title: Could a policy of provision of hip protectors to elderly nursing home residents result in cost savings in acute hip fracture care? The case of Ontario, Canada.
abstract: Hip fractures are an important problem in nursing homes. Hip protectors are external devices that decrease the risk of hip fracture in elderly nursing home residents. We estimated the overall healthcare cost savings from a hypothetical strategy of provision of hip protectors to elderly nursing home residents in Ontario, Canada. In a recent meta-analysis, we determined that a strategy of provision of hip protectors decreases the risk of hip fracture in nursing home residents.
  
  
  BACKGROUND
  Our objective was to determine whether the provision of hip protectors to all Ontario nursing home residents aged > or =65 years could result in cost savings, stemming from reductions in initial hospitalizations for hip fracture.
  
  
  METHODS
  We conducted a cost analysis from a Ministry of Health perspective (one year cycle length). The efficacy of the intervention was estimated from a meta-analysis of randomized controlled trials.
  
  
  RESULTS
  A strategy of provision of hip protectors to all 60,775 elderly Ontario nursing home residents could result in an overall mean cost savings of 6.0 million Canadian dollars in one year (95% credibility interval, -26.4 million, 39.7 million), with a probability of cost savings of 0.63 (assuming no additional labor costs). In sensitivity analyses, decreasing hip protector price increased cost savings, whereas additional labor expenditures for application for hip protectors decreased cost savings.
  
  
  CONCLUSIONS
  In conclusion, if hip protectors can be provided to elderly Ontario nursing home residents without additional labor expenditures, there is a reasonable probability that such a strategy may result in healthcare cost savings.
authors.affiliation: Division of Endocrinology and Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: Sawka
authors.forename: A
authors.initials: A
authors.lastname: Gafni
authors.forename: P
authors.initials: P
authors.lastname: Boulos
authors.forename: K
authors.initials: K
authors.lastname: Beattie
authors.forename: A
authors.initials: A
authors.lastname: Papaioannou
authors.forename: A
authors.initials: A
authors.lastname: Cranney
authors.forename: D A
authors.initials: DA
authors.lastname: Hanley
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
authors.forename: A
authors.initials: A
authors.lastname: Cheung
authors.forename: E A
authors.initials: EA
authors.lastname: Papadimitropoulos
authors.forename: L
authors.initials: L
authors.lastname: Thabane
mesh_terms: D000368:Aged; D017046:Cost Savings / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D017048:Health Care Costs / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D009864:Ontario / Q000453:epidemiology; D011482:Protective Devices / Q000191:economics*; D016032:Randomized Controlled Trials as Topic