Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures
Background/Purpose: Hip fractures are associated with physical dysfunction, and poor quality of life in the elderly. Post-acute care (PAC) would facilitate functional recovery in patients with hip fractures after surgeries. Taiwan has proposed a nationwide PAC program for hip fractures since 2017, b...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S092966462200002X |
| _version_ | 1818194167258415104 |
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| author | Min-Chang Lee Chia-Wei Chang Shih-Liang Shih Sheng-Jean Huang Jau-Yih Tsauo Kai-Lun Hsiao Meng-Yueh Chien |
| author_facet | Min-Chang Lee Chia-Wei Chang Shih-Liang Shih Sheng-Jean Huang Jau-Yih Tsauo Kai-Lun Hsiao Meng-Yueh Chien |
| author_sort | Min-Chang Lee |
| collection | DOAJ |
| description | Background/Purpose: Hip fractures are associated with physical dysfunction, and poor quality of life in the elderly. Post-acute care (PAC) would facilitate functional recovery in patients with hip fractures after surgeries. Taiwan has proposed a nationwide PAC program for hip fractures since 2017, but little has been known about its effectiveness. Therefore, this study aimed to evaluate the efficacy and cost-effectiveness of the PAC program for hip fracture patients in Taiwan. Methods: This was a prospective study. Patients aged ≥ 65 years with hip fractures after surgeries were recruited and divided into home-based, hospital-based, and control groups. Outcome measures included pain, physical function (sit-to-stand test, Barthel Index [BI], and Harris hip score [HHS]), and quality of life (EuroQol instrument [EQ-5D]). Direct medical and non-medical costs were recorded. Cost-effectiveness ratio (CER) was calculated as the amount of New Taiwanese Dollars (NTDs) paid per BI and EQ-5D unit improvement. Results: Forty-one patients participated in this study, with 17, 12, and 12 in the home-based, hospital-based, and control groups, respectively. The home-based group showed significant improvements in BI and HHS compared to the controls (p = 0.018 and p = 0.029, respectively). The hospital-based group demonstrated significant improvement in EQ-5D compared to the controls (p = 0.015). The home-based PAC program demonstrated the best CER for BI (NTD 554) and EQ-5D (NTD 41948). Conclusion: Both PAC programs would significantly improve the physical function and quality of life in patients with hip fractures. However, the home-based PAC provided the best CER for BI and EQ-5D. |
| first_indexed | 2024-12-12T00:57:59Z |
| format | Article |
| id | doaj.art-c80f0487828e47ef8ee9b2717900bfaf |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-12T00:57:59Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-c80f0487828e47ef8ee9b2717900bfaf2022-12-22T00:43:49ZengElsevierJournal of the Formosan Medical Association0929-66462022-08-01121815961604Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fracturesMin-Chang Lee0Chia-Wei Chang1Shih-Liang Shih2Sheng-Jean Huang3Jau-Yih Tsauo4Kai-Lun Hsiao5Meng-Yueh Chien6Center for Athletic Health Management, Taipei City Hospital, Renai Branch, Taipei, Taiwan; School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, TaiwanCenter for Athletic Health Management, Taipei City Hospital, Renai Branch, Taipei, TaiwanDepartment of Orthopaedic, Taipei City Hospital, Zhongxing Branch, Taipei, TaiwanTaipei City Hospital, Taipei, Taiwan; Department of Surgery, College of Medicine, National Taiwan University, Taipei, TaiwanSchool and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Orthopaedic, Taipei City Hospital, Zhongxing Branch, Taipei, TaiwanSchool and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Corresponding author. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3, No.17, Xuzhou Road, Zhongzheng District, Taipei City 100, Taiwan. Fax: +886 2 33668161.Background/Purpose: Hip fractures are associated with physical dysfunction, and poor quality of life in the elderly. Post-acute care (PAC) would facilitate functional recovery in patients with hip fractures after surgeries. Taiwan has proposed a nationwide PAC program for hip fractures since 2017, but little has been known about its effectiveness. Therefore, this study aimed to evaluate the efficacy and cost-effectiveness of the PAC program for hip fracture patients in Taiwan. Methods: This was a prospective study. Patients aged ≥ 65 years with hip fractures after surgeries were recruited and divided into home-based, hospital-based, and control groups. Outcome measures included pain, physical function (sit-to-stand test, Barthel Index [BI], and Harris hip score [HHS]), and quality of life (EuroQol instrument [EQ-5D]). Direct medical and non-medical costs were recorded. Cost-effectiveness ratio (CER) was calculated as the amount of New Taiwanese Dollars (NTDs) paid per BI and EQ-5D unit improvement. Results: Forty-one patients participated in this study, with 17, 12, and 12 in the home-based, hospital-based, and control groups, respectively. The home-based group showed significant improvements in BI and HHS compared to the controls (p = 0.018 and p = 0.029, respectively). The hospital-based group demonstrated significant improvement in EQ-5D compared to the controls (p = 0.015). The home-based PAC program demonstrated the best CER for BI (NTD 554) and EQ-5D (NTD 41948). Conclusion: Both PAC programs would significantly improve the physical function and quality of life in patients with hip fractures. However, the home-based PAC provided the best CER for BI and EQ-5D.http://www.sciencedirect.com/science/article/pii/S092966462200002XCost-effectiveness analysisHip fracturesHome-based careHospital-based carePost-acute care |
| spellingShingle | Min-Chang Lee Chia-Wei Chang Shih-Liang Shih Sheng-Jean Huang Jau-Yih Tsauo Kai-Lun Hsiao Meng-Yueh Chien Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures Journal of the Formosan Medical Association Cost-effectiveness analysis Hip fractures Home-based care Hospital-based care Post-acute care |
| title | Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures |
| title_full | Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures |
| title_fullStr | Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures |
| title_full_unstemmed | Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures |
| title_short | Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures |
| title_sort | efficacy and cost effectiveness analysis of post acute care for elderly patients with hip fractures |
| topic | Cost-effectiveness analysis Hip fractures Home-based care Hospital-based care Post-acute care |
| url | http://www.sciencedirect.com/science/article/pii/S092966462200002X |
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