The Cost-effectiveness of a Co-managed Care Model for Elderly Hip Fracture Patients in China: a Modelling Study

Overview

Journal Lancet Reg Health West Pac

Date 2024 Aug 13

PMID 39135908

Authors

Lizheng Xu

Minghui Yang

Xinyi Zhang

Jing Zhang

Jiusheng He

Liangyuan Wen

Xianhai Wang

Zongxin Shi

Sanbao Hu

Fengpo Sun

Zishun Gong

Mingyao Sun

Ke Peng

Pengpeng Ye

Ruofei Ma

Xinbao Wu

Mingsheng Chen

Stephen Jan

Rebecca Ivers

Maoyi Tian

Lei Si

Affiliations

Soon will be listed here.

Abstract

Background: The clinical effectiveness of multidisciplinary co-managed care for hip fracture patients in China has been demonstrated in a multicenter non-randomized controlled study. This study aims to estimate the cost-effectiveness of the co-managed care.

Methods: The study is based on a multicenter clinical trial (n = 2071) in China. We developed a state transition microsimulation model to estimate the cost-effectiveness of the co-managed care compared with usual care for hip fracture patients from healthcare system perspective. The costs incorporated into the model included hospitalization costs, post-discharge expenses, and secondary fracture therapy costs. Effectiveness was measured using quality-adjusted life years (QALYs). Costs and effects were discounted at 5% annually. A simulation cycle length of 1-year and a lifetime horizon were employed. The cost-effectiveness threshold was established at USD 37,118. To address uncertainties, one-way deterministic sensitivity analysis and probabilistic sensitivity analysis were conducted.

Findings: In the base case analysis, the co-managed care group had a lifetime cost of USD 31,571 and achieved an effectiveness of 3.22 QALYs, whereas the usual care group incurred a cost of USD 27,878 and gained 2.85 QALYs. The incremental cost-effectiveness ratio was USD 9981 per QALY gained; thus the co-managed care model was cost-effective. The cost-effectiveness was sensitive to the age of having hip fractures and hospitalization costs in the intervention group.

Interpretation: The co-managed care in hip fracture patients represents value for money, and should be scaled up and prioritized for funding in China.

Funding: The study is supported by Capital's Funds for Health Improvement and Research (2022-1-2071, 2018-1-2071).

Citing Articles

Construction and validation of a predictive model for the risk of prolonged preoperative waiting time in patients with intertrochanteric fractures.

Gong R, Jin X, Xu L, Zhang Z, Yuan D, Xie W Front Med (Lausanne). 2025; 11:1503719.

PMID: 39895817 PMC: 11782220. DOI: 10.3389/fmed.2024.1503719.

A real-world analysis of 1,823 hospitalized osteoporotic fractures in Northeast China.

Meng Q, Wang X, Gao Y, Leslie W, Lix L, Shi X Front Endocrinol (Lausanne). 2025; 15():1520229.

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