Jürisson M, Pisarev H, Kanis J, Borgström F, Svedbom A, Kallikorm R, Lember M, Uusküla A
Department of Public Health, University of Tartu, Ravila 19, 50411, Tartu, Estonia.
Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
Osteoporos Int. 2016 Aug;27(8):2555-66. doi: 10.1007/s00198-016-3544-4. Epub 2016 Feb 23.
We assessed the impact of hip fracture on health-related quality of life (HRQoL) and costs in Estonia. The mean 18-month HRQoL loss in quality adjusted life years (QALY) was estimated at 0.31, and the average cumulative cost from a societal perspective was 8146 euros per hip fracture patient.
The aim of this study is to estimate the impact of hip fracture on HRQoL, resource consumption, and cost over 18 months after the fracture among individuals aged over 50 in Estonia.
A cohort of 205 hip fracture patients ≥50 years was followed up for 18 months. HRQoL was estimated before fracture (recall), after fracture, and at 4, 12, and 18 months using the EQ-5D instrument. Health care utilization and costs were obtained from a public health insurance fund database; social, informal, and indirect costs were estimated using patient-reported data.
Hip fracture resulted in the mean 18-month HRQoL loss of 0.31 QALYs. The mean 18-months cumulative cost of hip fracture from a societal perspective was estimated at 8146 (95 % CI 6236-10717) euros per patient. Most of the cost was related to health care (56 %) and informal care (33 %), while social care contributed only 5 %. Utilization of outpatient rehabilitation and nursing care was low (8 % of patients).
The impact of hip fracture on HRQoL and cost was substantial. Despite appropriate inpatient care, utilization of rehabilitation, nursing care, and social care were low and potentially insufficient to meet the needs of patients with low HRQoL. The shortfall may partially explain a remarkably high use of informal care.
我们评估了髋部骨折对爱沙尼亚健康相关生活质量（HRQoL）和成本的影响。估计18个月质量调整生命年（QALY）中的平均HRQoL损失为0.31，从社会角度来看，每位髋部骨折患者的平均累计成本为8146欧元。
本研究的目的是估计髋部骨折对爱沙尼亚50岁以上个体骨折后18个月内的HRQoL、资源消耗和成本的影响。
对205名年龄≥50岁的髋部骨折患者进行了为期18个月的随访。使用EQ-5D工具在骨折前（回忆）、骨折后以及4、12和18个月时评估HRQoL。医疗保健利用情况和成本来自公共医疗保险基金数据库；社会、非正式和间接成本使用患者报告的数据进行估计。
髋部骨折导致平均18个月的HRQoL损失为0.31 QALYs。从社会角度来看，髋部骨折的平均18个月累计成本估计为每位患者8146（95%可信区间6236 - 10717）欧元。大部分成本与医疗保健（56%）和非正式护理（33%）相关，而社会护理仅占5%。门诊康复和护理的利用率较低（患者的8%）。
髋部骨折对HRQoL和成本的影响很大。尽管有适当的住院治疗，但康复、护理和社会护理的利用率较低，可能不足以满足HRQoL较低患者的需求。这种不足可能部分解释了非正式护理的高使用率。
