A cost-consequence analysis of a community-based rehabilitation programme following hip fracture (Fracture in the Elderly Multidisciplinary Rehabilitation-FEMuR III).
{"title":"A cost-consequence analysis of a community-based rehabilitation programme following hip fracture (Fracture in the Elderly Multidisciplinary Rehabilitation-FEMuR III).","authors":"Kodchawan Doungsong, Jacob Davies, Victory Ezeofor, Llinos Haf Spencer, Nefyn Williams, Rhiannon Tudor Edwards","doi":"10.1007/s00198-025-07459-4","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p><p><strong>Purpose: </strong>To explore the costs and consequences of the new FEMuR III intervention compared to usual care after hip fractures.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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%).</p><p><strong>Trial registration: </strong>ISRCTN28376407.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Osteoporosis International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00198-025-07459-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
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%).
期刊介绍：
An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases.
It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition.
While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
