PharmacoEconomics & Outcomes News 804, p17 - 2 Jun 2018 Hospital costs for hip fracture vary according to unit costs Estimated costs of hospital care for hip fracture in England vary based on the national unit costs used, according to findings of a cost-utility analysis published in PharmacoEconomics. Investigators compared the use of the three main diagnosis-related group (DRG)-based national unit costs in England to assess whether different approaches impacted the outcomes of economic evaluations. A Markov model, populated with data from Hospital Episode Statistics records and Clinical Practice Research Datalink records for 13 906 patients over 60 years of age with an emergency hospital admission for hip fracture, was used to compare three secondary fracture prevention models of care in patients with hip fracture: introduction of an orthogeriatrician-led service focussed on recovery after hip fracture; introduction of a nurse- led fracture liaison service focussing on secondary fracture prevention; or standard post-hip fracture care. Cost effectiveness was assessed using each of the three DRG-based national unit costs, from the English National Health Service (NHS) perspective and a personal social services payer perspective over a lifetime time horizon. Total hospital costs for hip fracture varied between £10 749 and £14 440 per fracture in the NHS, depending on the set of unit costs used. Use of finished consultant episode (FCE)-level reference costs resulted in the highest estimated hospital admission costs (£9075 per patient) and highest hospital care costs during the year after the fracture (£14 440). Use of spell- level tariffs resulted in the lowest total hospital care costs per patient during the year after fracture, £3691 lower than use of FCE-level costs, and £2106 lower than use of spell-level reference costs. At a willingness-to-pay threshold of £20 000 per QALY gained, use of spell-level reference costs or spell-level tariffs showed that the most cost-effective intervention was introduction of a nurse-led fracture liaison service model of care. However, use of FCE-level reference costs showed that usual care was the most cost-effective option. "Our results show that, conditional on the set of national unit costs adopted, the cost of diseases may vary considerably and different policy decisions may be made regarding the introduction of new healthcare interventions. The variability in cost estimates may impair healthcare planning and any misallocation of scarce healthcare resources may ultimately lead to suboptimal patient health outcomes, reducing population health," concluded the investigators. * 2014/2015 US dollars Leal J, et al. The Impact of Hospital Costing Methods on Cost-Effectiveness Analysis: A Case Study. PharmacoEconomics : 22 May 2018. Available from: URL: http://doi.org/10.1007/s40273-018-0673-y 803324095 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804
PharmacoEconomics & Outcomes News – Springer Journals
Published: Jun 2, 2018
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