A cost-utility analysis of a comprehensive orthogeriatric care for hip fracture patients, compared with standard of care treatment.
BACKGROUND
The economic burden associated with hip fractures calls for the investigation of innovative new cost-utility forms of organisation and integration of services for these patients.


OBJECTIVE
To carry out a cost-utility analysis integrating epidemiological and economic aspects for hip fracture patients treated within a comprehensive orthogeriatric model (COGM) of care, as compared with standard of care model (SOCM).


METHODS
A demonstration study conducted in a major tertiary medical centre, operating both a COGM ward and standard orthopaedic and rehabilitation wards.


METHODS
Data was collected on the clinical outcomes and health care costs of the two different treatment modalities, in order to calculate the absolute cost and disability-adjusted life years (DALY) ratio.


RESULTS
The COGM model used 23% fewer resources per patient ($14,919 vs. $19,363) than the SOCM model and to avert 0.226 additional DALY per patient, mainly as a result of lower 1-year mortality rates among COGM patients (14.8% vs. 17.3%).


CONCLUSIONS
A comprehensive ortho-geriatric care modality is more cost-effective, providing additional quality-adjusted life years (QALY) while using fewer resources compared with standard of care approach. The results should assist health policy-makers in optimising healthcare use and healthcare planning.
Sheba Medical Centre, The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv - Israel.
Gary
G
Ginsberg
Abraham
A
Adunsky
Iris
I
Rasooly
D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000191:economics* / Q000379:methods; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000191:economics* / Q000601:surgery; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D059039:Standard of Care