Murphy Aileen, de Blasio Federica, Kirby Ann, de Foubert Marguerite, Naughton Corina
Department of Economics, Cork University Business School, University College Cork, Ireland.
School of Nursing and Midwifery, University College Cork, Ireland.
J Frailty Sarcopenia Falls. 2024 Sep 1;9(3):218-226. doi: 10.22540/JFSF-09-218. eCollection 2024 Sep.
To conduct an economic cost analysis and budget impact assessment (BIA) of implementing the Frailty Care Bundle (FCB) intervention nationally over five-years for hip fracture patients. The FCB was designed to reduce hospital associated decline in older hospitalised patients.
The FCB was delivered in two Irish hospitals on two wards per hospital. A micro level cost analysis, from the Irish health service perspective was undertaken. Direct costs of the FCB were considered (personnel, training, resources), expressed in Euros (2020). For the BIA national population estimates for hip fracture and costs avoided were based on 18% difference in patients returning to their baseline capability in the post compared to pre-intervention group, valued using cost estimates of functional decline.
We estimated total intervention costs at €53,619 (89% for personnel) and the average cost per patient was €156.03. The expected costs of implementing the FCB nationally over 12-months was €57,274 per hospital (€72.92 per patient). The BIA for an expected targeted population (16,000 over 5 years), estimated that the cost of implementing the FCB (€1.2m) was less than the expected value of functional decline avoided owing to the intervention (€3.6m), suggesting a positive net effect (€2.4m).
Investment in the FCB can be offset with more rapid patient return to baseline functional capability, reducing health care costs. Trial and Protocol Registration (retrospective): BMC ISRCTN 15145850, (https://doi.org/10.1186/ISRCTN15145850).
对在全国范围内针对髋部骨折患者实施为期五年的衰弱护理包（FCB）干预措施进行经济成本分析和预算影响评估（BIA）。FCB旨在减少老年住院患者与医院相关的功能衰退。
在爱尔兰的两家医院各选取两个病房实施FCB。从爱尔兰医疗服务的角度进行微观层面的成本分析。考虑了FCB的直接成本（人员、培训、资源），以欧元（2020年）表示。对于BIA，髋部骨折的全国人口估计数以及避免的成本是基于与干预前组相比，干预后患者恢复到基线能力的差异为18%，使用功能衰退的成本估计值进行评估。
我们估计干预总成本为53,619欧元（89%为人员成本），每位患者的平均成本为156.03欧元。在全国范围内实施FCB 12个月的预期成本为每家医院57,274欧元（每位患者72.92欧元）。对于预期的目标人群（5年内16,000人）的BIA估计，实施FCB的成本（120万欧元）低于因干预避免的功能衰退的预期价值（360万欧元），表明有正的净效应（240万欧元）。
对FCB的投资可以通过患者更快恢复到基线功能能力来抵消，从而降低医疗成本。试验和方案注册（回顾性）：BMC ISRCTN 15145850，（https://doi.org/10.1186/ISRCTN15145850）。
