X. Surís , M.J. Pueyo-Sánchez , A. Ricart , A. Naranjo , T. Casanova , C. Gómez-Vaquero , E. Duaso , J.M. Cancio-Trujillo , J. Sánchez-Martín , A. Pérez-Mitru
{"title":"[加泰罗尼亚骨折联络服务的成本效益分析]。","authors":"X. Surís , M.J. Pueyo-Sánchez , A. Ricart , A. Naranjo , T. Casanova , C. Gómez-Vaquero , E. Duaso , J.M. Cancio-Trujillo , J. Sánchez-Martín , A. Pérez-Mitru","doi":"10.1016/j.jhqr.2024.03.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service.</p></div><div><h3>Methods</h3><p>Cost-utility assessment through a Markov model that simulated disease progression of a patients’ cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses.</p></div><div><h3>Results</h3><p>Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case.</p></div><div><h3>Conclusions</h3><p>The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Análisis de coste-efectividad de las Unidades de Coordinación de Fracturas en Cataluña\",\"authors\":\"X. Surís , M.J. Pueyo-Sánchez , A. Ricart , A. Naranjo , T. Casanova , C. Gómez-Vaquero , E. Duaso , J.M. Cancio-Trujillo , J. Sánchez-Martín , A. Pérez-Mitru\",\"doi\":\"10.1016/j.jhqr.2024.03.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service.</p></div><div><h3>Methods</h3><p>Cost-utility assessment through a Markov model that simulated disease progression of a patients’ cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses.</p></div><div><h3>Results</h3><p>Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case.</p></div><div><h3>Conclusions</h3><p>The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective.</p></div>\",\"PeriodicalId\":37347,\"journal\":{\"name\":\"Journal of Healthcare Quality Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Healthcare Quality Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S260364792400023X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Healthcare Quality Research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S260364792400023X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Análisis de coste-efectividad de las Unidades de Coordinación de Fracturas en Cataluña
Objective
To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service.
Methods
Cost-utility assessment through a Markov model that simulated disease progression of a patients’ cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses.
Results
Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case.
Conclusions
The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective.
期刊介绍:
Revista de Calidad Asistencial (Quality Healthcare) (RCA) is the official Journal of the Spanish Society of Quality Healthcare (Sociedad Española de Calidad Asistencial) (SECA) and is a tool for the dissemination of knowledge and reflection for the quality management of health services in Primary Care, as well as in Hospitals. It publishes articles associated with any aspect of research in the field of public health and health administration, including health education, epidemiology, medical statistics, health information, health economics, quality management, and health policies. The Journal publishes 6 issues, exclusively in electronic format. The Journal publishes, in Spanish, Original works, Special and Review Articles, as well as other sections. Articles are subjected to a rigorous, double blind, review process (peer review)