Extracapsular hip fracture management: Cost-consequences analysis of two alternative operative methods

Abstract

The quite similar performance of the two operative techniques suggests that cost could be the key factor for choosing between them. However, it is critical that many more randomized studies, with larger sample sizes and wider follow-up time periods should be conducted.

Fractures of the Femoral Neck and Proximal Femur

“…One trial compared a cemented arthroplasty with a sliding hip screw and the other a cemented arthroplasty with a proximal femoral nail. Here, the higher cost for arthroplasty is a key factor when the outcome is similar as found by Papakonstantinou et al [109] who prospectively compared osteosynthesis with hemiarthroplasty.…”

Socioeconomic value of orthopedic devices: evidence and methodological challenges

“…10,14,18,25,31,[35][36][37] The other most frequently mentioned challenges included uncertainty around the data parameters used and the concern about the representativeness of the patient population or study setting, 9,12,14,22,24,30,32 which would impact the generalizability of the findings. In relation to the issue around data uncertainty, several researchers mentioned the fact that some of the data needed for the analyses were either not available or were of too poor quality to use with any confidence.…”

“…9,12,20,24,33,38 Short study time horizons and small sample sizes in the clinical studies in this field were also highlighted. 22,25,35,37,39,40 Moreover, for many of the studies, important outcomes, including quality of life, a full range of relevant costs, and long-term outcomes, were not collected, which may limit their ability to capture fully the value of these devices. 9,16,18,26,29,34,37,40 While few analysts gave specific reasons why such outcomes were not considered, it was noted across several studies that the summary benefit measure used (eg, fractures avoided) did not capture quality of life and, in some cases, there were inherent deficiencies in some of the measures used, such as clinical scoring and health-related quality of life instruments.…”

“…March et al 25 Rasanen et al 32 Keating et al 30 Bozic et al 26 Honkanen et al 12 SooHoo et al 20 Slover et al 21 Coon et al 42 Gandjour et al 13 McBryde et al 36 Duwelius et al 6 Chang et al 23 Rorabeck et al 18 Clinkscales and Peterson 40 Rissanen et al 19 Lorenze et al 37 Givon et al 17 Gartsman et al 39 Kumar and Parker McKenzie et al 22 Briggs et al 31 Fielden et al 15 Meyer et al 8 38 Honkanen et al 24 Karuppiah et al 14 Papakonstantinou et al 35 Marinelli et al…”

Επιπτώσεις Των Καταγμάτων Ισχίου Στη Λειτουργικότητα Του Ασθενή

“…Στο κόστος αυτό συνυπολογίζονται η νοσοκομειακή νοσηλεία, τα υλικά τα οποία χρησιμοποιούνται κατά τη χειρουργική επέμβαση και η παροχή φυσιοθεραπείας ή νοσηλευτικής φροντίδας στο σπίτι [Πασπάτη και συν 2002]. Σύμφωνα με πιο πρόσφατη μελέτη στον Ελλαδικό χώρο, το κόστος για τον ασθενή που υποβάλλετο σε οστεοσύνθεση έφτανε τα 1.931 Euros ανά περιστατικό, ενώ για εκείνους που υποβάλλονταν σε ημιαρθροπλαστική το κόστος έφτανε τα 3.719 Euros ανά περιστατικό [Papakonstantinou VV et al 2008].…”