Cost-Effectiveness of Physical Rehabilitation and Care of Older Home-Dwelling Persons after Hip Fracture: A Systematic Review and Narrative Synthesis.
Jonas Ammundsen Ipsen, Lars T Pedersen, Eva Draborg and 3 others
PMID 36314360WHAT IT FOUND
Only 1 of 3 hip fracture rehabilitation interventions was cost-effective: comprehensive geriatric care in a geriatric ward.
The others were not. This is economic evidence, not proof that one therapy is clinically better.
Key findings
01The review included only 3 economic evaluations of physical rehabilitation and care after hip fracture, and the interventions differed in content and timing.
02Only 1 of the 3 interventions was shown to be cost-effective, comprehensive geriatric assessment at a geriatric ward.
03Two of the interventions did not show a significant QALY difference from usual physical rehabilitation and care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 3 studies were included, so the review could not combine results or give clear recommendations. The interventions differed in content and start time after surgery, and the studies used different cost collection methods and quality-of-life weights. Not all studies were of high quality, and 2 reported cost-effectiveness ratios based on statistically insignificant effect differences. The studies followed people for 6, 8, or 12 months, so long-term nursing home admission effects were not captured. The healthcare-sector perspective omitted some costs, including informal care, which is important for older people after hip fracture. Transferability to Nordic systems was limited, especially for the Australian study.
Declared interests
The authors state they have no conflicts of interest to declare.
The easy way to misread this
Do not conclude that the two programmes were clinically ineffective. The review assessed cost per quality-adjusted life year, and the QALY differences in those studies were not statistically significant.