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Published in: Osteoporosis International 8/2016

01-08-2016 | Original Article

Quality of life, resource use, and costs related to hip fracture in Estonia

Authors: M. Jürisson, H. Pisarev, J. Kanis, F. Borgström, A. Svedbom, R. Kallikorm, M. Lember, A. Uusküla

Published in: Osteoporosis International | Issue 8/2016

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Abstract

Summary

We assessed the impact of hip fracture on health-related quality of life (HRQoL) and costs in Estonia. The mean 18-month HRQoL loss in quality adjusted life years (QALY) was estimated at 0.31, and the average cumulative cost from a societal perspective was 8146 euros per hip fracture patient.

Introduction

The aim of this study is to estimate the impact of hip fracture on HRQoL, resource consumption, and cost over 18 months after the fracture among individuals aged over 50 in Estonia.

Methods

A cohort of 205 hip fracture patients ≥50 years was followed up for 18 months. HRQoL was estimated before fracture (recall), after fracture, and at 4, 12, and 18 months using the EQ-5D instrument. Health care utilization and costs were obtained from a public health insurance fund database; social, informal, and indirect costs were estimated using patient-reported data.

Results

Hip fracture resulted in the mean 18-month HRQoL loss of 0.31 QALYs. The mean 18-months cumulative cost of hip fracture from a societal perspective was estimated at 8146 (95 % CI 6236–10717) euros per patient. Most of the cost was related to health care (56 %) and informal care (33 %), while social care contributed only 5 %. Utilization of outpatient rehabilitation and nursing care was low (8 % of patients).

Conclusions

The impact of hip fracture on HRQoL and cost was substantial. Despite appropriate inpatient care, utilization of rehabilitation, nursing care, and social care were low and potentially insufficient to meet the needs of patients with low HRQoL. The shortfall may partially explain a remarkably high use of informal care.
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Literature
6.
go back to reference Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. doi:10.1007/s11657-013-0136-1 CrossRefPubMedPubMedCentral Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. doi:10.​1007/​s11657-013-0136-1 CrossRefPubMedPubMedCentral
7.
go back to reference Borgstrom F, Lekander I, Ivergard M et al (2013) The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)—quality of life during the first 4 months after fracture. Osteoporos Int 24:811–823. doi:10.1007/s00198-012-2240-2 CrossRefPubMed Borgstrom F, Lekander I, Ivergard M et al (2013) The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)—quality of life during the first 4 months after fracture. Osteoporos Int 24:811–823. doi:10.​1007/​s00198-012-2240-2 CrossRefPubMed
20.
go back to reference Walters SJ (2009) Quality of life outcomes in clinical trials and health-care evaluation: a practical guide to analysis and interpretation. John Wiley & Sons Walters SJ (2009) Quality of life outcomes in clinical trials and health-care evaluation: a practical guide to analysis and interpretation. John Wiley & Sons
23.
go back to reference Quan H, Sundararajan V, Halfon P et al (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43:1130–1139CrossRefPubMed Quan H, Sundararajan V, Halfon P et al (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43:1130–1139CrossRefPubMed
24.
go back to reference Quan H, Li B, Couris CM et al (2011) Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 173:676–682. doi:10.1093/aje/kwq433 CrossRefPubMed Quan H, Li B, Couris CM et al (2011) Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 173:676–682. doi:10.​1093/​aje/​kwq433 CrossRefPubMed
26.
go back to reference Tan-Torres Edejer T, Baltussen R, Adam T, et al. (2003) Making choices in health: WHO guide to cost-effectivess analysis. Tan-Torres Edejer T, Baltussen R, Adam T, et al. (2003) Making choices in health: WHO guide to cost-effectivess analysis.
29.
go back to reference Drummond MF (2005) Methods for the economic evaluation of health care programmes. Oxford University Press Drummond MF (2005) Methods for the economic evaluation of health care programmes. Oxford University Press
32.
go back to reference Si L, Winzenberg TM, de Graaff B, Palmer AJ (2014) A systematic review and meta-analysis of utility-based quality of life for osteoporosis-related conditions. Osteoporos Int. doi:10.1007/s00198-014-2636-2 Si L, Winzenberg TM, de Graaff B, Palmer AJ (2014) A systematic review and meta-analysis of utility-based quality of life for osteoporosis-related conditions. Osteoporos Int. doi:10.​1007/​s00198-014-2636-2
33.
go back to reference Ström O, Borgström F, Kanis JA et al (2011) Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155. doi:10.1007/s11657-011-0060-1 CrossRefPubMed Ström O, Borgström F, Kanis JA et al (2011) Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155. doi:10.​1007/​s11657-011-0060-1 CrossRefPubMed
35.
go back to reference Kudrna K, Krska Z (2005) Expense analysis of the proximal femoral fractures treatment. Rozhl Chir 84:631–634PubMed Kudrna K, Krska Z (2005) Expense analysis of the proximal femoral fractures treatment. Rozhl Chir 84:631–634PubMed
38.
go back to reference Nurmi I, Narinen A, Lüthje P, Tanninen S (2003) Cost analysis of hip fracture treatment among the elderly for the public health services: a 1-year prospective study in 106 consecutive patients. Arch Orthop Trauma Surg 123:551–554. doi:10.1007/s00402-003-0583-z CrossRefPubMed Nurmi I, Narinen A, Lüthje P, Tanninen S (2003) Cost analysis of hip fracture treatment among the elderly for the public health services: a 1-year prospective study in 106 consecutive patients. Arch Orthop Trauma Surg 123:551–554. doi:10.​1007/​s00402-003-0583-z CrossRefPubMed
39.
42.
go back to reference The World Bank Group (2015) The State of health care integration in Estonia The World Bank Group (2015) The State of health care integration in Estonia
Metadata
Title
Quality of life, resource use, and costs related to hip fracture in Estonia
Authors
M. Jürisson
H. Pisarev
J. Kanis
F. Borgström
A. Svedbom
R. Kallikorm
M. Lember
A. Uusküla
Publication date
01-08-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 8/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3544-4

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