中国大陆非置换性股骨颈骨折半关节成形术与内固定术的成本效益分析

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-08-29 DOI:10.3389/fsurg.2024.1437290

Shengchun Wang, Lingjie Tan, Bin Sheng

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引用次数: 0

摘要

目的股骨颈无移位骨折在股骨颈损伤中占很大比例。我们使用马尔可夫决策模型进行了一项成本效益分析，比较了 HA 和 IF 在治疗中国老年股骨颈非脱位骨折中的疗效。分析从支付方的角度进行，时间跨度为 5 年。成本以 2020 美元计算，疗效以质量调整生命年（QALYs）计算。为评估结果的稳健性，进行了包括单向分析和概率分析在内的敏感性分析。结果显示，与 IF（2.75）相比，HA 的累积 QALYs（2.94）更高，但总成本更高（13,324 美元对 12,167 美元），因此 ICER 为 6,128.52 美元/QALY。单向敏感性分析表明，HA 和 IF 的成本是影响最大的因素。概率敏感性分析表明，在69.3%的模拟中，HA更有效，在58.8%的模拟中，ICER低于11,083美元的支付意愿阈值。

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Hemiarthroplasty vs. internal fixation for nondisplaced femoral neck fracture in mainland China: a cost-effectiveness analysis

ObjectiveNondisplaced femoral neck fractures constitute a substantial portion of these injuries. The optimal treatment strategy between internal fixation (IF) and hemiarthroplasty (HA) remains debated, particularly concerning cost-effectiveness.MethodsWe conducted a cost-effectiveness analysis using a Markov decision model to compare HA and IF in treating nondisplaced femoral neck fractures in elderly patients in China. The analysis was performed from a payer perspective with a 5-year time horizon. Costs were measured in 2020 USD, and effectiveness was measured in quality-adjusted life-years (QALYs). Sensitivity analyses, including one-way and probabilistic analyses, were conducted to assess the robustness of the results. The willingness-to-pay threshold for incremental cost-effectiveness ratio (ICER) was set at $11,083/QALY following the Chinese gross domestic product in 2020.ResultsHA demonstrated higher cumulative QALYs (2.94) compared to IF (2.75) but at a higher total cost ($13,324 vs. $12,167), resulting in an ICER of $6,128.52/QALY. The one-way sensitivity analysis identified the costs of HA and IF as the most influential factors. Probabilistic sensitivity analysis indicated that HA was more effective in 69.3% of simulations, with an ICER below the willingness-to-pay threshold of $11,083 in 58.8% of simulations.ConclusionsHA is a cost-effective alternative to IF for treating nondisplaced femoral neck fractures in elderly patients in mainland China.

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.