Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Osteoporosis Reports
Published in: Current Osteoporosis Reports 3/2020

01-06-2020 | Care | Orthopedic Management of Fractures (M Kacena and L Gerstenfeld, Section Editors)

Developing Registries and Effective Care Models for the Management of Hip Fractures: Aligning Political, Organizational Drivers with Clinical Outcomes

Authors: Amy Hoang-Kim, Dubi Kanengisser

Published in: Current Osteoporosis Reports | Issue 3/2020

Login to get access

Abstract

Purpose of Review

The aim of the review is to conduct a literature search on cost-effectiveness or cost savings of osteoporosis fracture liaison services.

Recent Findings

We identified four types of FLS. A total of 11 cost-effectiveness studies examining 15 models of secondary fracture prevention models were identified. Nine models were found to be cost-saving, and five were found to be cost-effective.

Summary

It is possible to adopt a cost-effective model for fracture liaison services and expand across geographical regions. Adopting registries can have the added benefit of monitoring quality improvement practices and treatment outcomes. Challenges exist in implementing registries where centralized data collections across different chronic conditions are politically driving agendas. In order to align political and organizational strategic plans, a core set of outcome evaluations that are both focused on patient and provider experience in addition to treatment outcomes can be a step toward achieving better health and services.
Literature
1.
MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354.4:366–78.CrossRef
2.
Moore L, Clark DE. The value of trauma registries. Injury. 2008;39.5:686–95.CrossRef
3.
McNeil JJ, Evans SM, Johnson NP, Cameron PA. Clinical-quality registries: their role in quality improvement. Med J Aust. 2010;192.5:244–5.CrossRef
4.
5.
6.
7.
Black N, Payne M. Directory of clinical databases: improving and promoting their use. Qual Saf Health Care. 2003;12:348–52.CrossRef
8.
Agency for Healthcare Research and Quality. Registries for evaluating patient outcomes: a user’s guide. Rockville: Agency for Healthcare Research and Quality; 2006.
9.
Evans SM, Bohensky M, Cameron PA, McNeil J. A survey of Australian clinical registries: can quality of care be measured? Intern Med J. 2009;41.1a:42–8.
10.
Australian Commission on Safety and Quality in Health Care. Operating principles and technical standards for Australian clinical quality registries. 2008.
11.
12.
Stea S, Bordini B, De Clerico M, Petropulacos K, Toni A. First hip arthroplasty register in Italy: 55,000 cases and 7 year follow-up. Int Orthop. 2009;33(2):339–46.CrossRef
13.
Smith AJ, Dieppe P, Howard PW, Ashley W, Natl Joint Registry England Wales and National Joint Registry for England and Wales. Failure rates of metal-on-metal hip resurfacings: analysis of data from the National Joint Registry for England and Wales. Lancet. 2012;380.9855:1759–66.CrossRef
14.
15.
16.
17.
18.
Thorngren KG. In: Bentley G, editor. National registration of hip fractures in Sweden. New York: Springer & Science & Business Media; 2009.CrossRef
19.
Royal College of Physicians. Falls and Fragility Fracture Audit Programme (FFFAP) National Hip Fracture Database (NHFD) annual report 2014. London; 2014.
20.
Inacio MCS, Weiss JM, Miric A, Hunt JJ, Zohman GL, Paxton EW. A community-based hip fracture registry: population, methods, and outcomes. Perm J. 2015;19(3):29–36.PubMedPubMedCentral
21.
Boers M, Idzerda L, Kirwan JR. Toward a generalized framework of core measurement areas in clinical trials: a position paper for OMERACT 11. J Rheumatology 2014;4 (5):978–985.CrossRef
22.
• Liem IS, Kammerlander C, Suhm N, Blauth M, Roth T, Gosch M, et al. Identifying a standard set of outcome parameters for the evaluation of orthogeriatric co-management for hip fractures. Injury. 2013;44:1402–12 Expert panelists identify and discuss the merits and validity of a critical set of measures, when available and feasible, to capture change in patients with hip fracture. The evaluation cuts across different professions including orthogeriatricians. CrossRef
23.
Dyer SM, Crotty M, Fairhall N, Magaziner J, Beaupre LA, Cameron ID, et al. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr. 2016;16:158.CrossRef
24.
World Health Organization. Towards a common language for functioning disability and health. Geneva: World Health Organization; 2002.
25.
26.
• Ganda K, Puech M, Chen JS, Speerin R, Bleasel J, Center JR, et al. Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int. 2013;24.2:393–406 A comprehensive review including a thorough classification of Fracture Liaison services. CrossRef
27.
• Wu CH, Kao IJ, Hung WC, Lin SC, Liu HC, Hsieh MH, et al. Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature. Osteoporos Int. 2018;29.6:1227–42 The most recent and comprehensive systematic review of the economic aspects of Fracture Liaison Services currently available.CrossRef
28.
Sander B, Elliot-Gibson V, Beaton DE, Bogoch ER, Maetzel A. A coordinator program in post-fracture osteoporosis management improves outcomes and saves costs. J Bone Jt Surg. 2008;90(6):1197–205.CrossRef
29.
Majumdar SR, Lier DA, Beaupre LA, Hanley DA, Maksymowych WP, Juby AG, et al. Osteoporosis case manager for patients with hip fractures: results of a cost-effectiveness analysis conducted alongside a randomized trial. Arch Intern Med. 2009;169. 1:25.CrossRef
30.
Morrish DW, Beaupre LA, Bell NR, Cinats JG, Hanley DA, Harley CH, et al. Facilitated bone mineral density testing versus hospital-based case management to improve osteoporosis treatment for hip fracture patients: additional results from a randomized trial. Arthritis Rheum. 2009;61(2):209–15.CrossRef
31.
Majumdar SR, Lier DA, FA MA, Rowe BH, Siminoski K, Hanley DA, et al. Cost-effectiveness of osteoporosis interventions for “incidental” vertebral fractures. Am J Med. 2013;126.2:169 e9–169 e17.
32.
Majumdar SR, Lier D, Hanley DA, Juby AG, Beaupre LA. Economic evaluation of a population-based osteoporosis intervention for outpatients with non-traumatic non-hip fractures: the "Catch a Break" 1i [type c]. FLS. 2017;28.6:1965–77.
33.
Cooper MS, Palmer AJ, Seibel MJ. Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Osteoporos Int. 2012;23(1):97–107.CrossRef
34.
Osteoporosis Canada. Appendix C: best practices for post-fracture osteoporosis care; fracture liaison services. 2013.
35.
36.
McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, et al. Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int. 2011;22(7):2083–98.CrossRef
37.
38.
Leal J, Gray AM, Hawley S, Prieto-Alhambra D, Delmestri A, Arden NK, et al. Cost-effectiveness of Orthogeriatric and fracture liaison service models of care for hip fracture patients: a population-based study: cost-effectiveness of fracture liaison service models. J Bone Miner Res. 2017;32(2):203–11.CrossRef
39.
Walters S, Khan T, Ong T, Sahota O. Fracture liaison services: improving outcomes for patients with osteoporosis. Clin Interv Aging. 2017;12:117–27.CrossRef
40.
Yong JHE, Masucci L, Hoch JS, Sujic R, Beaton D. Cost-effectiveness of a fracture liaison service -- a real world evaluation after 6 years of service provision. Osteoporos Int. 2016;27(1):231–40.CrossRef
41.
Newman ED, Ayoub WT, Starkey RH, Diehl JM, Wood GC. Osteoporosis disease management in a rural health care population: hip fracture reduction and reduced costs in postmenopausal women after 5 years. Osteoporos Int. 2003;14(2):146–51.CrossRef
42.
43.
44.
Griffiths, EJ, Stevenson D, Porteous, MJ. Cost savings of using a cemented total hip replacement. An analysis of the National Joint Registry data. 94-B. 8, 2012. Pp. 2013-5.
45.
Pivec R, Johnson AJ, Mears SC. Hip Arthroplasty. Lancet. 2012;380(9855):1768–77.CrossRef
46.
Paxton EW, Inacio MCS, Kiley ML. The Kaiser Permanente implant registries: effect on patient safety, quality improvement, cost effectiveness, and research opportunities. Perm J. 2012;16(2):36–44.PubMedPubMedCentral
47.
Lindley R. Hip fracture: the case for a funded national registry. Lets implement what we know and avoid deaths from hip fracture. MJA. 2014;201(7):368–70.PubMed
Metadata
Title
Developing Registries and Effective Care Models for the Management of Hip Fractures: Aligning Political, Organizational Drivers with Clinical Outcomes
Authors
Amy Hoang-Kim
Dubi Kanengisser
Publication date
01-06-2020
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 3/2020
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-020-00582-7

Other articles of this Issue 3/2020

Current Osteoporosis Reports 3/2020 Go to the issue

Muscle and Bone (A Bonetto and M Brotto, Section Editors)

Pharmacologic Treatments to Preserve Bone and Muscle Mass in Osteosarcopenia

Kidney and Bone (IB Salusky and T Nickolas, Section Editors)

Transcriptomics: a Solution for Renal Osteodystrophy?

Orthopedic Management of Fractures (M Kacena and L Gerstenfeld, Section Editors)

Epidemiology, Clinical Assessments, and Current Treatments of Nonunions

Nutrition, Exercise and Lifestyle in Osteoporosis (S Shapses and R Daly, Section Editors)

Are Probiotics the New Calcium and Vitamin D for Bone Health?

Orthopedic Management of Fractures (M Kacena and L Gerstenfeld, Section Editors)

Imaging Modalities to Assess Fracture Healing

Rare Bone Disease (C Langman and E Shore, Section Editors)

Generalized Arterial Calcification of Infancy: New Insights, Controversies, and Approach to Management