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Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving

BACKGROUND: older adults in aged care account for 30% of the population burden of hip fractures. Nutritional interventions to correct under nutrition reduce these debilitating fractures, perhaps partly by reducing falls and slowing deterioration in bone morphology. OBJECTIVE: to determine whether a...

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Autores principales: Baek, Yeji, Iuliano, Sandra, Robbins, Judy, Poon, Shirley, Seeman, Ego, Ademi, Zanfina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10312131/
https://www.ncbi.nlm.nih.gov/pubmed/37389558
http://dx.doi.org/10.1093/ageing/afad114
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author Baek, Yeji
Iuliano, Sandra
Robbins, Judy
Poon, Shirley
Seeman, Ego
Ademi, Zanfina
author_facet Baek, Yeji
Iuliano, Sandra
Robbins, Judy
Poon, Shirley
Seeman, Ego
Ademi, Zanfina
author_sort Baek, Yeji
collection PubMed
description BACKGROUND: older adults in aged care account for 30% of the population burden of hip fractures. Nutritional interventions to correct under nutrition reduce these debilitating fractures, perhaps partly by reducing falls and slowing deterioration in bone morphology. OBJECTIVE: to determine whether a nutritional approach to fracture risk reduction in aged care homes is cost-effective. DESIGN: cost-effectiveness was estimated based on results from a prospective 2-year cluster-randomised controlled trial and secondary data. Intervention residents consumed a total of 3.5 daily servings of milk, yoghurt and/or cheese, resulting in 1,142 mg of calcium and 69 g of protein compared with the daily intakes of 700 mg of calcium and 58 g of protein consumed by the control group. SETTING: fifty-six aged care homes. PARTICIPANTS: residents for 27 intervention (n = 3,313) and 29 control (n = 3,911) homes. METHODS: ambulance, hospital, rehabilitation and residential care costs incurred by fracture were estimated. The incremental cost-effectiveness ratios per fracture averted within a 2-year time horizon were estimated from the Australian healthcare perspective applying a 5% discount rate on costs after the first year. RESULTS: intervention providing high-protein and high-calcium foods reduced fractures at a daily cost of AU$0.66 per resident. The base-case results showed that the intervention was cost-saving per fracture averted, with robust results in a variety of sensitivity and scenario analyses. Scaling the benefits of intervention equates to a saving of AU$66,780,000 annually in Australia and remained cost-saving up to a daily food expenditure of AU$1.07 per resident. CONCLUSIONS: averting hip and other non-vertebral fractures in aged care residents by restoring nutritional inadequacy of protein and calcium is cost-saving.
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spelling pubmed-103121312023-07-01 Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving Baek, Yeji Iuliano, Sandra Robbins, Judy Poon, Shirley Seeman, Ego Ademi, Zanfina Age Ageing Research Paper BACKGROUND: older adults in aged care account for 30% of the population burden of hip fractures. Nutritional interventions to correct under nutrition reduce these debilitating fractures, perhaps partly by reducing falls and slowing deterioration in bone morphology. OBJECTIVE: to determine whether a nutritional approach to fracture risk reduction in aged care homes is cost-effective. DESIGN: cost-effectiveness was estimated based on results from a prospective 2-year cluster-randomised controlled trial and secondary data. Intervention residents consumed a total of 3.5 daily servings of milk, yoghurt and/or cheese, resulting in 1,142 mg of calcium and 69 g of protein compared with the daily intakes of 700 mg of calcium and 58 g of protein consumed by the control group. SETTING: fifty-six aged care homes. PARTICIPANTS: residents for 27 intervention (n = 3,313) and 29 control (n = 3,911) homes. METHODS: ambulance, hospital, rehabilitation and residential care costs incurred by fracture were estimated. The incremental cost-effectiveness ratios per fracture averted within a 2-year time horizon were estimated from the Australian healthcare perspective applying a 5% discount rate on costs after the first year. RESULTS: intervention providing high-protein and high-calcium foods reduced fractures at a daily cost of AU$0.66 per resident. The base-case results showed that the intervention was cost-saving per fracture averted, with robust results in a variety of sensitivity and scenario analyses. Scaling the benefits of intervention equates to a saving of AU$66,780,000 annually in Australia and remained cost-saving up to a daily food expenditure of AU$1.07 per resident. CONCLUSIONS: averting hip and other non-vertebral fractures in aged care residents by restoring nutritional inadequacy of protein and calcium is cost-saving. Oxford University Press 2023-06-29 /pmc/articles/PMC10312131/ /pubmed/37389558 http://dx.doi.org/10.1093/ageing/afad114 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Research Paper
Baek, Yeji
Iuliano, Sandra
Robbins, Judy
Poon, Shirley
Seeman, Ego
Ademi, Zanfina
Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving
title Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving
title_full Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving
title_fullStr Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving
title_full_unstemmed Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving
title_short Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving
title_sort reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10312131/
https://www.ncbi.nlm.nih.gov/pubmed/37389558
http://dx.doi.org/10.1093/ageing/afad114
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