Economic evaluation of operative versus nonoperative treatment of a humeral shaft fracture: economic analyses alongside a multicenter prospective cohort study (HUMMER)

Autor: Van Bergen, Saskia H., Van Lieshout, Esther M.M., Mahabier, Kiran C., Geraerds, Alexandra J.L.M., Polinder, Suzanne, Den Hartog, Dennis, Verhofstad, Michael H.J., Notenboom, Marije
Přispěvatelé: Surgery, AMS - Musculoskeletal Health, Graduate School, APH - Methodology, CCA - Imaging and biomarkers, Other Research, Public Health, Erasmus MC other, Anesthesiology, General Practice, Radiotherapy, APH - Quality of Care
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: European journal of trauma. Urban und Vogel
European Journal of Trauma and Emergency Surgery, 49(2), 929-938. Springer International Publishing AG
European Journal of Trauma and Emergency Surgery. Urban und Vogel
the HUMMER Investigators 2022, ' Economic evaluation of operative versus nonoperative treatment of a humeral shaft fracture : economic analyses alongside a multicenter prospective cohort study (HUMMER) ', European Journal of Trauma and Emergency Surgery . https://doi.org/10.1007/s00068-022-02160-1
ISSN: 1863-9933
Popis: Purpose Operative treatment of a humeral shaft fracture results in faster recovery than nonoperative treatment. The cost-effectiveness, in terms of costs per Quality-Adjusted Life Year (QALY) gained (Dutch threshold €20,000-€80,000) or minimal important change (MIC) in disability reduced (DASH 6.7), is unknown. The aim of this study was to determine cost-utility and cost-effectiveness of operative versus nonoperative treatment in adults with a humeral shaft fracture type 12A or 12B. Methods This study was performed alongside a multicenter prospective cohort study. Costs for health care and lost productivity until one year after trauma were calculated. The incremental cost-utility ratio (ICUR) was reported in costs per QALY (based on the EuroQoL-5D-3L (EQ-5D)) gained. The incremental cost-effectiveness ratio (ICER) was reported in costs per MIC (based on the DASH score at three months) reduced. Results Overall, 245 patients were treated operatively and 145 nonoperatively. In the operative group, the mean total costs per patient (€11,925 versus €8793; p p i.e., €3132/0.028). The DASH was 7.3 points (p i.e., €3132/7.3*6.7). Conclusion Due to the limited effect of treatment on quality of life measured with the EQ-5D, the ICUR of operative treatment (€111,860 per QALY gained) exceeds the threshold. However, the incremental costs of €2880 per clinically meaningful difference in DASH are much lower and suggest that operative treatment for a humeral shaft fracture is cost-effective.
Databáze: OpenAIRE
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