Cost-effectiveness of individualized nutrition and exercise therapy for rehabilitation following hip fracture
Rachel Milte, Michelle D. Miller, Maria Crotty, Shylie Mackintosh, Susie Thomas, Ian D. Cameron, Craig Whitehead, Susan Kurrle, Julie Ratcliffe
Rehabilitation, Aged and Extended Care, Flinders University, 5001 Adelaide, Australia. E-mail: firstname.lastname@example.org
Objective: To undertake a cost-utility analysis of the Individual Nutrition Therapy and Exercise Regime: A Controlled Trial of Injured, Vulnerable Elderly (INTERACTIVE) trial.
Design: Cost-utility analysis of a randomized controlled trial.
Subjects: A total of 175 patients following a hip fracture were allocated to receive either alternate weekly visits from a physical therapist and dietitian (intervention group), or social visits for 6 months (control group).
Methods: Costs for utilization of hospitals, health and community services were compared with quality-adjusted life years gained, calculated from responses to the Assessment of Quality of Life instrument.
Results: There were minimal differences in mean costs between the intervention ($AUD 45,331 standard deviation (SD): $AUD 23,012) and the control group ($AUD 44,764 SD: $AUD 20,712, p = 0.868), but a slightly higher mean gain in quality-adjusted life years in the intervention group (0.155, SD: 0.132) compared with the control group (0.139, SD: 0.149, p = 0.470). The incremental cost-effectiveness ratio was $AUD 28,350 per quality-adjusted life year gained, which is below the implied cost-effectiveness threshold utilized by regulatory authorities in Australia.
Conclusion: A comprehensive 6-month programme of therapy from dietitians and physical therapists could be provided at a relatively low additional cost in this group of frail older adults, and the incremental cost-effectiveness ratio indicates likely cost-effectiveness, although there was a very high level of uncertainty in the findings.
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