Orthogeriatric Model of Care is Cost-Effective for Elderly Patients With Hip Fractures

HealthDay News — For 83-year-old patients with hip fracture, an orthogeriatric model of care is effective and cost-effective, according to research published in the Journal of Bone and Mineral Research.

Jose Leal, DPhil, from the University of Oxford in the United Kingdom, and colleagues examined the cost-effectiveness of orthogeriatric and nurse-led fracture liaison service models of post-hip fracture care compared with usual care. A Markov model was used to estimate the lifetime impact of the models. The base-case population comprised 83-year-old men and women with a hip fracture. Large primary and hospital care datasets in the United Kingdom were used to derive the risk and costs of hip and non-hip fractures.

The researchers found that at a threshold of £30,000 per quality-adjusted life-year (QALY) gained, the orthogeriatric-led service was the most effective and cost-effective model of care in the base-case analysis. The orthogeriatric-led service was most cost-effective at £22,709 per QALY for women aged 83 years. Orthogeriatric-led service was cost-effective at £12,860 per QALY and £14,525 per QALY for women and men aged 83 years, respectively, if only health care costs were considered.

“Although, considerable uncertainty remains concerning which of the models of care should be preferred, introducing an orthogeriatrician-led service seems to be the most cost-effective service to pursue,” the researchers wrote.

Disclosures: Several researchers received grants from NIHR HS & DR during the study. Outside the submitted work, several researchers disclosed relationships with one or more of the following: Lilly UK, Amgen, Sevier, Merck, Medtronic, Internis, Consilient Health, National Osteoporosis Society and International Osteoporosis Foundation, Bioiberica S.A., Amgen Spain S.A., Novartis, Smith and Nephew, Q-Med, Nicox, Flexion, Roche, UK Renal Registry, Oxford Craniofacial Unit, IDIAP Jordi Gol, Freshfields Bruckhaus Deringer, and Anthera Pharmaceuticals.

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  1. Leal J, Gray AM, Hawley S, et al; REFReSH Study Group. Cost-effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: A population based study [published online September 16, 2016]. J Bone Miner Res. doi:10.1002/jbmr.2995.