TY - JOUR
T1 - A micro-costing analysis of post-fracture care pathways
T2 - results from the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)
AU - Talevski, J.
AU - Sanders, K. M.
AU - Lal, A.
AU - Watts, J. J.
AU - Beauchamp, A.
AU - Duque, G.
AU - Borgström, F.
AU - Kanis, J. A.
AU - Svedbom, A.
AU - Brennan-Olsen, S. L.
N1 - Funding Information:
Open Access funding enabled and organized by CAUL and its Member Institutions JT was supported by an Australian National Health and Medical Research Council (NHMRC, of Australia) Postgraduate Scholarship (1151089). On its international level, the ICUROS is sponsored by Amgen, Eli Lilly, Medtronic, Novartis, Sanofi-Aventis, Servier, and Pfizer. In Australia, the study was supported by the National Health and Medical Research Council with supplementary funding from Merck Pty Ltd. In Austria, the study was sponsored by Central Association of Austrian Social Security Institution, Austrian Society for Bone and Mineral Research (AuSBMR), Merck Sharp & Dohme, Servier GmbH, Medtronic GmbH, Amgen GmbH, Novartis GmbH, Nycomed GmbH, Roche GmbH, Sanofi-Aventis GmbH, and Daiichi-Sankyo GmbH. In Mexico, the study was supported by CONACyT. In Lithuania, the work was supported by the National Osteoporosis Center. In the USA, Amgen Inc., Ingenix Pharmaceutical Services, Eli Lilly and Company, Medtronic Spine LLC, and Pfizer (formerly Wyeth) sponsored the study. Hoffmann La Roche and Amgen provided support. In Estonia, the study was supported by the Estonian Science Foundation, and the Estonian Ministry of Education and Research. In Russia, the study was supported by Hoffmann La Roche, Amgen, and the Russian Osteoporosis Association.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/9
Y1 - 2022/9
N2 - Summary: This study identified the costs and health-related quality of life impacts of several post-fracture multidisciplinary care pathways specific to individual skeletal site (hip, distal forearm, vertebrae, humerus). These care pathways may assist healthcare providers in allocating resources for osteoporotic fractures in more effective and cost-efficient ways. Introduction: This micro-costing study was undertaken to provide the estimated healthcare costs of several fracture site-specific health service use pathways associated with different trajectories of health-related quality of life (HRQoL) 12-months post-fracture. Methods: The study included 4126 adults aged ≥ 50 years with a fragility fracture (1657 hip, 681 vertebrae, 1354 distal forearm, 434 humerus) from the International Costs & Utilities Related to Osteoporotic fractures Study (ICUROS). ICUROS participants were asked to recall the frequency and duration (where applicable) of their health and community care service use at 4- and 12-month follow-up visits. Patient-level costs were identified and aggregated to determine the average cost of healthcare use related to the fracture in each care pathway (presented in Australian 2021 dollars). Mean cost differences were calculated and analysed using a one-way analysis of variance (ANOVA) and post hoc Bonferroni correction to determine any statistically significant differences. Results: The total direct cost of fractures was estimated at $89564, $38926, $18333, and $38461AUD per patient for hip, vertebral, wrist, and humeral participants, respectively. A Kruskal–Wallis test yielded a statistically significant difference in cost values between most care pathways (p < 0.001). Of the 20 care pathways, those associated with recovery of HRQoL had lower mean costs per patient across each fracture site. Conclusions: This study identified the costs and HRQoL impacts of several multidisciplinary care pathways for individual fracture sites based on the health service utilization of an international cohort of older adults. These care pathways may assist healthcare providers in allocating resources for fragility fractures in more effective and cost-efficient ways.
AB - Summary: This study identified the costs and health-related quality of life impacts of several post-fracture multidisciplinary care pathways specific to individual skeletal site (hip, distal forearm, vertebrae, humerus). These care pathways may assist healthcare providers in allocating resources for osteoporotic fractures in more effective and cost-efficient ways. Introduction: This micro-costing study was undertaken to provide the estimated healthcare costs of several fracture site-specific health service use pathways associated with different trajectories of health-related quality of life (HRQoL) 12-months post-fracture. Methods: The study included 4126 adults aged ≥ 50 years with a fragility fracture (1657 hip, 681 vertebrae, 1354 distal forearm, 434 humerus) from the International Costs & Utilities Related to Osteoporotic fractures Study (ICUROS). ICUROS participants were asked to recall the frequency and duration (where applicable) of their health and community care service use at 4- and 12-month follow-up visits. Patient-level costs were identified and aggregated to determine the average cost of healthcare use related to the fracture in each care pathway (presented in Australian 2021 dollars). Mean cost differences were calculated and analysed using a one-way analysis of variance (ANOVA) and post hoc Bonferroni correction to determine any statistically significant differences. Results: The total direct cost of fractures was estimated at $89564, $38926, $18333, and $38461AUD per patient for hip, vertebral, wrist, and humeral participants, respectively. A Kruskal–Wallis test yielded a statistically significant difference in cost values between most care pathways (p < 0.001). Of the 20 care pathways, those associated with recovery of HRQoL had lower mean costs per patient across each fracture site. Conclusions: This study identified the costs and HRQoL impacts of several multidisciplinary care pathways for individual fracture sites based on the health service utilization of an international cohort of older adults. These care pathways may assist healthcare providers in allocating resources for fragility fractures in more effective and cost-efficient ways.
KW - Ageing
KW - Economics
KW - Fractures
KW - Osteoporosis
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85131819508&partnerID=8YFLogxK
U2 - 10.1007/s00198-022-06460-5
DO - 10.1007/s00198-022-06460-5
M3 - Article
C2 - 35701629
AN - SCOPUS:85131819508
SN - 0937-941X
VL - 33
SP - 1895
EP - 1907
JO - Osteoporosis International
JF - Osteoporosis International
IS - 9
ER -