一项基于社区的髋部骨折康复计划的成本-后果分析（老年骨折多学科康复-FEMuR III）。

A cost-consequence analysis of a community-based rehabilitation programme following hip fracture (Fracture in the Elderly Multidisciplinary Rehabilitation-FEMuR III).

作者信息

Doungsong Kodchawan, Davies Jacob, Ezeofor Victory, Spencer Llinos Haf, Williams Nefyn, Edwards Rhiannon Tudor

机构信息

Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK.

University of South Wales, Pontypridd, UK.

出版信息

Osteoporos Int. 2025 May;36(5):883-892. doi: 10.1007/s00198-025-07459-4. Epub 2025 Mar 26.

DOI:10.1007/s00198-025-07459-4

PMID:40137951

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12089205/

Abstract

UNLABELLED

The FEMuR III economic evaluation presents costs and consequences of the intervention compared with usual care at 52-week follow-up. There was no evidence of clinical effectiveness in terms of improvement of quality of life, and the total health service costs were higher in the intervention group.

PURPOSE

To explore the costs and consequences of the new FEMuR III intervention compared to usual care after hip fractures.

METHODS

This cost-consequence analysis accompanies the FEMuR III randomised controlled trial using a micro-costing approach. The main outcome measures in this economic evaluation were healthcare service use, costs, and quality of life over 12 months, from both National Health Service and wider societal perspectives. Quality of life was measured using the EuroQoL-5D-3L.

RESULTS

The mean cost of delivering the intervention was £444 per participant. For participants with complete EQ-5D data (n = 142), both groups showed improvement in EQ-5D index score, moving scores closer to UK norms. Participants in the intervention group gained 0.02 (95% CI: - 0.036, 0.076) more quality-adjusted life years (QALYs) than the usual care group. However, this was not statistically significant (p value = 0.312). For imputed cases, participants in the intervention group gained less QALYs than the usual care by 0.01 (95% CI: - 0.056, 0.030). For participants with complete cost data (n = 115), at 52-week follow-up, mean health service use costs were higher in the intervention group from both perspectives.

CONCLUSIONS

The mean health service use costs were higher in the intervention group due to longer inpatient stays. There was no significant difference in QALYs between both groups. The trial was affected by the COVID-19 pandemic, and this goes some way to explaining the large proportion of missing data (40%).

TRIAL REGISTRATION

ISRCTN28376407.

摘要

未标注

FEMuR III经济评估呈现了干预措施与常规护理在52周随访时的成本和结果。在改善生活质量方面没有临床有效性的证据，且干预组的总医疗服务成本更高。

目的

探讨与髋部骨折后的常规护理相比，新型FEMuR III干预措施的成本和结果。

方法

本成本-结果分析伴随FEMuR III随机对照试验，采用微观成本核算方法。从英国国家医疗服务体系（National Health Service）和更广泛的社会视角来看，本次经济评估的主要结局指标是12个月内的医疗服务使用情况、成本和生活质量。生活质量使用欧洲五维健康量表（EuroQoL-5D-3L）进行测量。

结果

实施干预措施的平均成本为每位参与者444英镑。对于拥有完整EQ-5D数据的参与者（n = 142），两组的EQ-5D指数得分均有所改善，得分更接近英国标准。干预组的参与者比常规护理组多获得0.02（95%置信区间：-0.036，0.076）个质量调整生命年（QALYs）。然而，这在统计学上并不显著（p值 = 0.312）。对于估算病例，干预组的参与者比常规护理组少获得0.01（95%置信区间：-0.056，0.030）个QALYs。对于拥有完整成本数据的参与者（n = 115），在52周随访时，从两个视角来看，干预组的平均医疗服务使用成本更高。