The effectiveness of a co-management care model on older hip fracture patients in China – A multicentre non-randomised controlled study

L. Xu, M. Yang, X. Zhang, J. Zhang, J. He, L. Wen, X. Wang, Z. Shi, S. Hu, F. Sun, Z. Gong, M. Sun, K. Peng, P. Ye, R. Ma, X. Wu, M. Chen, S. Jan, R. Ivers, M. TianLei Si

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34 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Findings: 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. Interpretation: The co-managed care in hip fracture patients represents value for money, and should be scaled up and prioritized for funding in China.
Original languageEnglish
Article number100348
Number of pages13
JournalThe Lancet Regional Health - Western Pacific
Volume19
Publication statusPublished - Feb 2022

Bibliographical note

Publisher Copyright:
© 2021 The Authors

Open Access - Access Right Statement

© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Keywords

  • Hip fracture
  • China
  • Older people
  • Co-management care
  • Orthogeriatric care

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