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Tytuł pozycji:

IS HIP FRACTURE REHABILITATION FOR NURSING HOME RESIDENTS COST-EFFECTIVE? RESULTS FROM AN RCT

Tytuł :
IS HIP FRACTURE REHABILITATION FOR NURSING HOME RESIDENTS COST-EFFECTIVE? RESULTS FROM AN RCT
Autorzy :
Kaambwa, B.
Ratcliffe, J.
Killington, M.
Liu, E.
Cameron, I.
Kurrle, S.
Davies, O.
Crotty, M.
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Temat :
Abstracts
Wydawca :
Oxford University Press, 2017.
Rok publikacji :
2017
Oryginalny identyfikator :
pmc: PMC6185551
Język :
English
DOI :
10.1093/geroni/igx004.3401
Organised multidisciplinary rehabilitation after hip fracture is costly but likely to improve outcomes for nursing home patients who frequently suffer with dementia. Cost-effectiveness evidence of such rehabilitation is however lacking. Using data from nursing home residents who were walking (independently, with aids or with assistance) prior to fracture, we examined the relative cost-effectiveness of post-operative outreach rehabilitation compared to usual nursing home care. An economic evaluation was conducted alongside a randomised controlled trial with 240 patients: intervention (post-operative rehabilitation) (n = 121) or usual care (n = 119) with 4 weeks and 12 month follow-up (at this stage, only 4-week results are reported in the paper). The primary and secondary outcomes were incremental costs per unit improvement in mobility (measured using the Nursing Home Life-Space Diameter - NHLSD) and incremental costs per quality adjusted year (QALY) based on the DemQoL-Proxy, respectively. Mean Australian total healthcare costs were higher in the intervention compared to usual care by $1,750/patient. Mean NHLSD scores and QALYs were also higher in the intervention (by 2.71 and 0.0023/patient, respectively) resulting in incremental cost-effectiveness ratios of $645/unit improvement in the NHLSD and $760,870/QALY gain. At a willingness-to-pay (WTP) threshold of $3,000 per unit improvement in the NHLSD, there was an 80% chance that the intervention was the cost-effective option. Compared to usual care, post-operative rehabilitation leads to increased mobility at a low WTP threshold and is also associated with higher QALYs. Further research should consider the cost-effectiveness of an extended post-operative rehabilitation intervention in this population.

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