Ginsberg Gary, Adunsky Abraham, Rasooly Iris
Sheba Medical Centre, The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv - Israel.
Hip Int. 2013 Nov-Dec;23(6):570-5. doi: 10.5301/hipint.5000080. Epub 2013 Aug 9.
The economic burden associated with hip fractures calls for the investigation of innovative new cost-utility forms of organisation and integration of services for these patients.
To carry out a cost-utility analysis integrating epidemiological and economic aspects for hip fracture patients treated within a comprehensive orthogeriatric model (COGM) of care, as compared with standard of care model (SOCM).
A demonstration study conducted in a major tertiary medical centre, operating both a COGM ward and standard orthopaedic and rehabilitation wards.
Data was collected on the clinical outcomes and health care costs of the two different treatment modalities, in order to calculate the absolute cost and disability-adjusted life years (DALY) ratio.
The COGM model used 23% fewer resources per patient ($14,919 vs. $19,363) than the SOCM model and to avert 0.226 additional DALY per patient, mainly as a result of lower 1-year mortality rates among COGM patients (14.8% vs. 17.3%).
A comprehensive ortho-geriatric care modality is more cost-effective, providing additional quality-adjusted life years (QALY) while using fewer resources compared with standard of care approach. The results should assist health policy-makers in optimising healthcare use and healthcare planning.
髋部骨折相关的经济负担促使人们对针对这些患者的创新型成本效用组织形式和服务整合方式进行研究。
与标准护理模式（SOCM）相比，对在综合老年骨科护理模式（COGM）下接受治疗的髋部骨折患者进行成本效用分析，整合流行病学和经济方面的因素。
在一家大型三级医疗中心进行的示范研究，该中心设有COGM病房以及标准的骨科和康复病房。
收集两种不同治疗方式的临床结果和医疗保健成本数据，以计算绝对成本和伤残调整生命年（DALY）比率。
与SOCM模式相比，COGM模式每位患者使用的资源减少23%（14,919美元对19,363美元），且每位患者可避免0.226个额外的DALY，这主要是由于COGM患者的1年死亡率较低（14.8%对17.3%）。
与标准护理方法相比，综合老年骨科护理模式更具成本效益，在使用更少资源的同时可提供额外的质量调整生命年（QALY）。这些结果应有助于卫生政策制定者优化医疗保健利用和医疗保健规划。
