PDF(Pubmed)
Abstract：
UNASSIGNED: The clinical effectiveness of multidisciplinary co-managed care for hip fracture patients in China has been demonstrated in a multicenter non-randomized controlled study. This study aims to estimate the cost-effectiveness of the co-managed care.
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).
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).
摘要：
■一项多中心非随机对照研究证明了中国多学科联合管理治疗髋部骨折患者的临床有效性。本研究旨在评估共同管理护理的成本效益。
■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。
■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。
