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Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan.
Chien, Li-Nien; Li, Yi-Fan; Yang, Rong-Sen; Yang, Tsung-Han; Chen, Yi-Han; Huang, Wei-Jia; Tsai, Hsin-Yi; Li, Chun-Yi; Chan, Ding-Cheng.
Afiliación
  • Chien LN; School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.
  • Li YF; Division of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taiwan.
  • Yang RS; Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan.
  • Yang TH; Department of Orthopedics, Hsinchu Branch, National Taiwan University Hospital, Hsinchu County, Taiwan.
  • Chen YH; School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
  • Huang WJ; Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
  • Tsai HY; Amgen Taiwan Ltd, Taipei, Taiwan.
  • Li CY; Amgen Taiwan Ltd, Taipei, Taiwan.
  • Chan DC; Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Superintendent Office, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:
J Formos Med Assoc ; 121(1 Pt 2): 425-433, 2022 Jan.
Article en En | MEDLINE | ID: mdl-34144861
BACKGROUND: This study was to perform an economic evaluation to understand clinical outcomes and health resource use between hip fracture patients receiving hospital-based postfracture fracture liaison service (FLS) care and those receiving usual care (UC) in Taiwan. METHODS: This cohort study included hospital-based data of 174 hip fracture patients who received FLS care (FLS group) from National Taiwan University Hospital, and 1697 propensity score-matched patients who received UC (UC group) of National Health Insurance claim-based data. Two groups had similar baseline characteristics but differed in hip fracture care after propensity score matching. Clinical outcomes included refracture-free survival (RFS), hip-refracture-free survival (HRFS), and overall survival (OS). Health resource use included inpatient, outpatient, and pharmacy costs within 2 years follow-up after the index of hip fracture. The economic evaluation of the FLS model was analyzed using the net monetary benefit regression framework based on the National Health Insurance perspective. RESULTS: The FLS group had longer RFS than the UC group, with an adjusted difference of 44.3 days (95% confidence interval: 7.2-81.4 days). Two groups did not differ in inpatient and outpatient costs during follow-up, but the FLS group had a higher expenditure than the UC group on osteoporosis-related medication. The probability of FLS being cost-effective was >80% and of increasing RFS, HRFS, and OS was 95%, 81%, and 80%, respectively, when the willingness-to-pay threshold was >USD 65/gross domestic product per day. CONCLUSION: FLS care was cost-effective in reducing refracture occurrence days for patients initially diagnosed with hip fractures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas de Cadera Tipo de estudio: Etiology_studies / Evaluation_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Humans País/Región como asunto: Asia Idioma: En Revista: J Formos Med Assoc Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Singapur
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas de Cadera Tipo de estudio: Etiology_studies / Evaluation_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Humans País/Región como asunto: Asia Idioma: En Revista: J Formos Med Assoc Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Singapur