Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan
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 inclu...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-01-01
|
| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664621002436 |
| _version_ | 1819174562919612416 |
|---|---|
| author | Li-Nien Chien Yi-Fan Li Rong-Sen Yang Tsung-Han Yang Yi-Han Chen Wei-Jia Huang Hsin-Yi Tsai Chun-Yi Li Ding-Cheng Chan |
| author_facet | Li-Nien Chien Yi-Fan Li Rong-Sen Yang Tsung-Han Yang Yi-Han Chen Wei-Jia Huang Hsin-Yi Tsai Chun-Yi Li Ding-Cheng Chan |
| author_sort | Li-Nien Chien |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T20:40:57Z |
| format | Article |
| id | doaj.art-8b73a8222ac64404894b3f6621cec0cd |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-22T20:40:57Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-8b73a8222ac64404894b3f6621cec0cd2022-12-21T18:13:20ZengElsevierJournal of the Formosan Medical Association0929-66462022-01-011211425433Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in TaiwanLi-Nien Chien0Yi-Fan Li1Rong-Sen Yang2Tsung-Han Yang3Yi-Han Chen4Wei-Jia Huang5Hsin-Yi Tsai6Chun-Yi Li7Ding-Cheng Chan8School of Health Care Administration, College of Management, Taipei Medical University, Taipei, TaiwanDivision of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare, TaiwanDepartment of Orthopedics, National Taiwan University Hospital, Taipei, TaiwanDepartment of Orthopedics, Hsinchu Branch, National Taiwan University Hospital, Hsinchu County, TaiwanSchool of Public Health, College of Public Health, Taipei Medical University, Taipei, TaiwanDepartment of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, TaiwanAmgen Taiwan Ltd, Taipei, TaiwanAmgen Taiwan Ltd, Taipei, TaiwanDepartment 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; Corresponding author. Department of Geriatrics and Gerontology, National Taiwan University Hospital, No.25, Ln 442, Jingguo Rd, Hsinchu City 30059, Taiwan.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.http://www.sciencedirect.com/science/article/pii/S0929664621002436Hip fractureFracture liaison service (FLS)Net monetary benefitCost-effectiveness analysis |
| spellingShingle | Li-Nien Chien Yi-Fan Li Rong-Sen Yang Tsung-Han Yang Yi-Han Chen Wei-Jia Huang Hsin-Yi Tsai Chun-Yi Li Ding-Cheng Chan Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan Journal of the Formosan Medical Association Hip fracture Fracture liaison service (FLS) Net monetary benefit Cost-effectiveness analysis |
| title | Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan |
| title_full | Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan |
| title_fullStr | Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan |
| title_full_unstemmed | Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan |
| title_short | Real-world cost-effectiveness analysis of the fracture liaison services model of care for hip fracture in Taiwan |
| title_sort | real world cost effectiveness analysis of the fracture liaison services model of care for hip fracture in taiwan |
| topic | Hip fracture Fracture liaison service (FLS) Net monetary benefit Cost-effectiveness analysis |
| url | http://www.sciencedirect.com/science/article/pii/S0929664621002436 |
| work_keys_str_mv | AT linienchien realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT yifanli realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT rongsenyang realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT tsunghanyang realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT yihanchen realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT weijiahuang realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT hsinyitsai realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT chunyili realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan AT dingchengchan realworldcosteffectivenessanalysisofthefractureliaisonservicesmodelofcareforhipfractureintaiwan |