UNASSIGNED: The study is based on a multicenter clinical trial (n = 2071) in China. We developed a state transition microsimulation model to estimate the cost-effectiveness of the co-managed care compared with usual care for hip fracture patients from healthcare system perspective. The costs incorporated into the model included hospitalization costs, post-discharge expenses, and secondary fracture therapy costs. Effectiveness was measured using quality-adjusted life years (QALYs). Costs and effects were discounted at 5% annually. A simulation cycle length of 1-year and a lifetime horizon were employed. The cost-effectiveness threshold was established at USD 37,118. To address uncertainties, one-way deterministic sensitivity analysis and probabilistic sensitivity analysis were conducted.
UNASSIGNED: In the base case analysis, the co-managed care group had a lifetime cost of USD 31,571 and achieved an effectiveness of 3.22 QALYs, whereas the usual care group incurred a cost of USD 27,878 and gained 2.85 QALYs. The incremental cost-effectiveness ratio was USD 9981 per QALY gained; thus the co-managed care model was cost-effective. The cost-effectiveness was sensitive to the age of having hip fractures and hospitalization costs in the intervention group.
UNASSIGNED: The co-managed care in hip fracture patients represents value for money, and should be scaled up and prioritized for funding in China.
UNASSIGNED: The study is supported by Capital\'s Funds for Health Improvement and Research (2022-1-2071, 2018-1-2071).
■该研究基于中国的多中心临床试验(n=2071)。我们开发了一种状态过渡微观模拟模型,以从医疗保健系统的角度评估与常规护理相比,共同管理的护理对髋部骨折患者的成本效益。纳入模型的费用包括住院费用,出院后费用,和二次骨折治疗费用。使用质量调整生命年(QALYs)衡量有效性。成本和效果每年折价5%。采用了1年的模拟周期长度和生命周期。成本效益阈值定为37,118美元。为了解决不确定性,进行了单向确定性敏感性分析和概率敏感性分析.
■在基本情况分析中,共同管理的护理小组的终生成本为31,571美元,并实现了3.22QALY的有效性,而常规护理组的费用为27,878美元,获得了2.85QALY。增量成本效益比为每QALY获得9981美元;因此,共同管理的护理模式具有成本效益。干预组的成本效益对髋部骨折的年龄和住院费用敏感。
■髋部骨折患者的共同管理护理物有所值,并应扩大规模并优先考虑在中国的资金。
■该研究得到了Capital的健康改善和研究基金(2022-1-2071,2018-1-2071)的支持。