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Expanding access to fracture liaison services in Australia for people with minimal trauma fractures: a system dynamics modelling study.
Jones, Alicia R; Currie, Danielle; Peng, Cindy; Ebeling, Peter R; Center, Jackie R; Duque, Gustavo; Lybrand, Sean; Lyubomirsky, Greg; Mitchell, Rebecca J; Pearson, Sallie; Seibel, Markus J; Occhipinti, Jo-An.
Afiliación
  • Jones AR; Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC.
  • Currie D; Monash Health, Melbourne, VIC.
  • Peng C; Sax Institute, Sydney, NSW.
  • Ebeling PR; Sax Institute, Sydney, NSW.
  • Center JR; Monash University, Melbourne, VIC.
  • Duque G; Garvan Institute of Medical Research, Sydney, NSW.
  • Lybrand S; St Vincent's Hospital Sydney, Sydney, NSW.
  • Lyubomirsky G; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, Melbourne, VIC.
  • Mitchell RJ; Western Health, Melbourne, VIC.
  • Pearson S; Amgen Europe, Rotkreuz, Switzerland.
  • Seibel MJ; Healthy Bones Australia, Sydney, NSW.
  • Occhipinti JA; Australian Institute of Health Innovation, Macquarie University, Sydney, NSW.
Med J Aust ; 220(5): 243-248, 2024 03 18.
Article en En | MEDLINE | ID: mdl-38409791
ABSTRACT

OBJECTIVES:

To project how many minimal trauma fractures could be averted in Australia by expanding the number and changing the operational characteristics of fracture liaison services (FLS). STUDY

DESIGN:

System dynamics modelling. SETTING,

PARTICIPANTS:

People aged 50 years or more who present to hospitals with minimal trauma fractures, Australia, 2020-31. MAIN OUTCOME

MEASURES:

Numbers of all minimal trauma fractures and of hip fractures averted by increasing the FLS number (from 29 to 58 or 100), patient screening rate (from 30% to 60%), and capacity for accepting new patients (from 40 to 80 per service per month), and reducing the proportion of eligible patients who do not attend FLS (from 30% to 15%); cost per fracture averted.

RESULTS:

Our model projected a total of 2 441 320 minimal trauma fractures (258 680 hip fractures; 2 182 640 non-hip fractures) in people aged 50 years or older during 2020-31, including 1 211 646 second or later fractures. Increasing the FLS number to 100 averted a projected 5405 fractures (0.22%; $39 510 per fracture averted); doubling FLS capacity averted a projected 3674 fractures (0.15%; $35 835 per fracture averted). Our model projected that neither doubling the screening rate nor reducing by half the proportion of eligible patients who did not attend FLS alone would reduce the number of fractures. Increasing the FLS number to 100, the screening rate to 60%, and capacity to 80 new patients per service per month would together avert a projected 13 672 fractures (0.56%) at a cost of $42 828 per fracture averted.

CONCLUSION:

Our modelling indicates that increasing the number of hospital-based FLS and changing key operational characteristics would achieve only moderate reductions in the number of minimal trauma fractures among people aged 50 years or more, and the cost would be relatively high. Alternatives to specialist-led, hospital-based FLS should be explored.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoporosis / Conservadores de la Densidad Ósea / Fracturas Osteoporóticas / Fracturas de Cadera Límite: Humans País/Región como asunto: Oceania Idioma: En Revista: Med J Aust Año: 2024 Tipo del documento: Article Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoporosis / Conservadores de la Densidad Ósea / Fracturas Osteoporóticas / Fracturas de Cadera Límite: Humans País/Región como asunto: Oceania Idioma: En Revista: Med J Aust Año: 2024 Tipo del documento: Article Pais de publicación: Australia