دورية أكاديمية
Should major trauma fractures be part of a fracture liaison service's remit: a cost-benefit estimate.
| العنوان: | Should major trauma fractures be part of a fracture liaison service's remit: a cost-benefit estimate. |
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| المؤلفون: | Chandrasoma D; Department of Rheumatology, Bone and Joint Centre Royal Newcastle Centre, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW, 2305, Australia.; Faculty of Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.; Hunter New England Health, John Hunter Hospital, Newcastle, NSW, Australia., Chiu S; Hunter Medical Research Institute, Newcastle, NSW, 2308, Australia., Niddrie F; Department of Rheumatology, Bone and Joint Centre Royal Newcastle Centre, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW, 2305, Australia.; Hunter New England Health, John Hunter Hospital, Newcastle, NSW, Australia., Major G; Department of Rheumatology, Bone and Joint Centre Royal Newcastle Centre, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW, 2305, Australia. Gabor.major@health.nsw.gov.au.; Faculty of Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia. Gabor.major@health.nsw.gov.au.; Hunter New England Health, John Hunter Hospital, Newcastle, NSW, Australia. Gabor.major@health.nsw.gov.au. |
| المصدر: | Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2024 Aug; Vol. 35 (8), pp. 1461-1467. Date of Electronic Publication: 2024 May 27. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: England NLM ID: 9100105 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-2965 (Electronic) Linking ISSN: 0937941X NLM ISO Abbreviation: Osteoporos Int Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London, UK : Springer International, c1990- |
| مواضيع طبية MeSH: | Cost-Benefit Analysis* , Osteoporotic Fractures*/economics , Osteoporotic Fractures*/prevention & control , Recurrence*, Humans ; Male ; Female ; Middle Aged ; Aged ; Health Care Costs/statistics & numerical data ; Aged, 80 and over ; Delivery of Health Care, Integrated/economics ; Delivery of Health Care, Integrated/organization & administration ; New England ; Secondary Prevention/economics ; Secondary Prevention/organization & administration |
| مستخلص: | The refracture rate after major trauma is approximately half (57%) the refracture rate after a minimal trauma injury. Extending Fracture Liaison Service activity to include major trauma patients creates significant additional direct cost, but remains essentially cost neutral if notional savings through refracture risk reduction are taken into account. Purpose: To compare the 3-year refracture rate following minimal trauma (MT) and non-minimal trauma (non-MT) injuries and evaluate the cost of extending fracture liaison service (FLS) operations to non-MT presentations. Methods: Patients aged 50, or above presenting to the John Hunter Hospital with a fracture in calendar year 2018 were identified through the Integrated Patient Management System (IPMS) of the Hunter New England Health Service's (HNEHS), and re-presentation to any HNEHS facility over the following 3 years monitored. The refracture rate of MT and non-MT presentations was compared and analysed using Cox proportional hazards regression models. The cost of including non-MT patients was estimated through the use of a previously conducted micro-costing analysis. The operational fidelity of the FLS to the previous estimate was confirmed by comparing the 3-year refracture rate of MT presentations in the two studies. Results: The 3-year refracture rate following a MT injury was 8% and after non-MT injury 4.5%. Extension of FLS activities to include non-MT patients in 2022 would have cost an additional $198,326 AUD with a notional loss/saving of $ - 26,625/ + 26,913 AUD through refracture risk reduction. No clinically available characteristic at presentation predictive of increased refracture risk was identified. Conclusion: The 3-year refracture after a non-MT injury is about half (57%) that of the refracture rate after a MT injury. Extending FLS activity to non-MT patients incurs a significant additional direct cost but remains cost neutral if notional savings gained through reduction in refracture risk are taken into account. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Fracture liaison service; Fractures; Health economics; Major trauma; Osteoporotic fractures prevention Minimal trauma; Refracture |
| تواريخ الأحداث: | Date Created: 20240527 Date Completed: 20240727 Latest Revision: 20240729 |
| رمز التحديث: | 20240729 |
| مُعرف محوري في PubMed: | PMC11282122 |
| DOI: | 10.1007/s00198-024-07134-0 |
| PMID: | 38802556 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1433-2965 |
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| DOI: | 10.1007/s00198-024-07134-0 |