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Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study

INTRODUCTION: Geriatric Fracture Centers (GFCs) are dedicated treatment units where care is tailored towards elderly patients who have suffered fragility fractures. The primary objective of this economic analysis was to determine the cost-utility of GFCs compared with usual care centres. METHODS: Th...

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Autores principales: Joeris, Alexander, Sprague, Sheila, Blauth, Michael, Gosch, Markus, Wattanapanom, Pannida, Jarayabhand, Rahat, Poeze, Martijn, Wong, Merng K, Kwek, Ernest B K, Hegeman, Johannes H, Perez-Uribarri, Carlos, Guerado, Enrique, Revak, Thomas J, Zohner, Sebastian, Joseph, David, Phillips, Mark R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626854/
https://www.ncbi.nlm.nih.gov/pubmed/37918921
http://dx.doi.org/10.1136/bmjopen-2023-072744
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author Joeris, Alexander
Sprague, Sheila
Blauth, Michael
Gosch, Markus
Wattanapanom, Pannida
Jarayabhand, Rahat
Poeze, Martijn
Wong, Merng K
Kwek, Ernest B K
Hegeman, Johannes H
Perez-Uribarri, Carlos
Guerado, Enrique
Revak, Thomas J
Zohner, Sebastian
Joseph, David
Phillips, Mark R
author_facet Joeris, Alexander
Sprague, Sheila
Blauth, Michael
Gosch, Markus
Wattanapanom, Pannida
Jarayabhand, Rahat
Poeze, Martijn
Wong, Merng K
Kwek, Ernest B K
Hegeman, Johannes H
Perez-Uribarri, Carlos
Guerado, Enrique
Revak, Thomas J
Zohner, Sebastian
Joseph, David
Phillips, Mark R
author_sort Joeris, Alexander
collection PubMed
description INTRODUCTION: Geriatric Fracture Centers (GFCs) are dedicated treatment units where care is tailored towards elderly patients who have suffered fragility fractures. The primary objective of this economic analysis was to determine the cost-utility of GFCs compared with usual care centres. METHODS: The primary analysis was a cost-utility analysis that measured the cost per incremental quality-adjusted life-year gained from treatment of hip fracture in GFCs compared with treatment in usual care centres from the societal perspective over a 1-year time horizon. The secondary analysis was a cost-utility analysis from a societal perspective over a lifetime time horizon. We evaluated these outcomes using a cost-utility analysis using data from a large multicentre prospective cohort study comparing GFCs versus usual care centres that took place in Austria, Spain, the USA, the Netherlands, Thailand and Singapore. RESULTS: GFCs may be cost-effective in the long term, while providing a more comprehensive care plan. Patients in usual care centre group were slightly older and had fewer comorbidities. For the 1-year analysis, the costs per patient were slightly lower in the GFC group (−$646.42), while the quality-adjusted life-years were higher in the usual care centre group (+0.034). The incremental cost-effectiveness ratio was $18 863.34 (US$/quality-adjusted life-year). The lifetime horizon analysis found that the costs per patient were lower in the GFC group (−$7210.35), while the quality-adjusted life-years were higher in the usual care centre group (+0.02). The incremental cost-effectiveness ratio was $320 678.77 (US$/quality-adjusted life-year). CONCLUSIONS: This analysis found that GFCs were associated with lower costs compared with usual care centres. The cost-savings were greater when the lifetime time horizon was considered. This comprehensive cost-effectiveness analysis, using data from an international prospective cohort study, found that GFC may be cost-effective in the long term, while providing a more comprehensive care plan. A greater number of major adverse events were reported at GFC, nevertheless a lower mortality rate associated with these adverse events at GFC. Due to the minor utility benefits, which may be a result of greater adverse event detection within the GFC group and much greater costs of usual care centres, the GFC may be cost-effective due to the large cost-savings it demonstrated over the lifetime time horizon, while potentially identifying and treating adverse events more effectively. These findings suggest that the GFC may be a cost-effective option over the lifetime of a geriatric patient with hip fracture, although future research is needed to further validate these findings. LEVEL OF EVIDENCE: Economic, level 2. TRIAL REGISTRATION NUMBER: NCT02297581.
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spelling pubmed-106268542023-11-07 Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study Joeris, Alexander Sprague, Sheila Blauth, Michael Gosch, Markus Wattanapanom, Pannida Jarayabhand, Rahat Poeze, Martijn Wong, Merng K Kwek, Ernest B K Hegeman, Johannes H Perez-Uribarri, Carlos Guerado, Enrique Revak, Thomas J Zohner, Sebastian Joseph, David Phillips, Mark R BMJ Open Geriatric Medicine INTRODUCTION: Geriatric Fracture Centers (GFCs) are dedicated treatment units where care is tailored towards elderly patients who have suffered fragility fractures. The primary objective of this economic analysis was to determine the cost-utility of GFCs compared with usual care centres. METHODS: The primary analysis was a cost-utility analysis that measured the cost per incremental quality-adjusted life-year gained from treatment of hip fracture in GFCs compared with treatment in usual care centres from the societal perspective over a 1-year time horizon. The secondary analysis was a cost-utility analysis from a societal perspective over a lifetime time horizon. We evaluated these outcomes using a cost-utility analysis using data from a large multicentre prospective cohort study comparing GFCs versus usual care centres that took place in Austria, Spain, the USA, the Netherlands, Thailand and Singapore. RESULTS: GFCs may be cost-effective in the long term, while providing a more comprehensive care plan. Patients in usual care centre group were slightly older and had fewer comorbidities. For the 1-year analysis, the costs per patient were slightly lower in the GFC group (−$646.42), while the quality-adjusted life-years were higher in the usual care centre group (+0.034). The incremental cost-effectiveness ratio was $18 863.34 (US$/quality-adjusted life-year). The lifetime horizon analysis found that the costs per patient were lower in the GFC group (−$7210.35), while the quality-adjusted life-years were higher in the usual care centre group (+0.02). The incremental cost-effectiveness ratio was $320 678.77 (US$/quality-adjusted life-year). CONCLUSIONS: This analysis found that GFCs were associated with lower costs compared with usual care centres. The cost-savings were greater when the lifetime time horizon was considered. This comprehensive cost-effectiveness analysis, using data from an international prospective cohort study, found that GFC may be cost-effective in the long term, while providing a more comprehensive care plan. A greater number of major adverse events were reported at GFC, nevertheless a lower mortality rate associated with these adverse events at GFC. Due to the minor utility benefits, which may be a result of greater adverse event detection within the GFC group and much greater costs of usual care centres, the GFC may be cost-effective due to the large cost-savings it demonstrated over the lifetime time horizon, while potentially identifying and treating adverse events more effectively. These findings suggest that the GFC may be a cost-effective option over the lifetime of a geriatric patient with hip fracture, although future research is needed to further validate these findings. LEVEL OF EVIDENCE: Economic, level 2. TRIAL REGISTRATION NUMBER: NCT02297581. BMJ Publishing Group 2023-11-02 /pmc/articles/PMC10626854/ /pubmed/37918921 http://dx.doi.org/10.1136/bmjopen-2023-072744 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Geriatric Medicine
Joeris, Alexander
Sprague, Sheila
Blauth, Michael
Gosch, Markus
Wattanapanom, Pannida
Jarayabhand, Rahat
Poeze, Martijn
Wong, Merng K
Kwek, Ernest B K
Hegeman, Johannes H
Perez-Uribarri, Carlos
Guerado, Enrique
Revak, Thomas J
Zohner, Sebastian
Joseph, David
Phillips, Mark R
Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study
title Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study
title_full Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study
title_fullStr Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study
title_full_unstemmed Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study
title_short Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study
title_sort cost-effectiveness analysis of the geriatric fracture center (gfc) concept: a prospective multicentre cohort study
topic Geriatric Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626854/
https://www.ncbi.nlm.nih.gov/pubmed/37918921
http://dx.doi.org/10.1136/bmjopen-2023-072744
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