Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee. 2: economic evaluation alongside a randomized controlled trial
| Autor: | D, Pinto, M C, Robertson, J H, Abbott, P, Hansen, A J, Campbell, Helen, Nicholson |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Marginal cost medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis Biomedical Engineering Severity of Illness Index Osteoarthritis Hip Gross domestic product law.invention Economic evaluation alongside clinical trials Physical medicine and rehabilitation Rheumatology Randomized controlled trial law medicine Per capita Humans Orthopedics and Sports Medicine health care economics and organizations Aged Aged 80 and over Cost–benefit analysis business.industry Health Care Costs Middle Aged Osteoarthritis Knee Combined Modality Therapy Musculoskeletal Manipulations Exercise Therapy Manual therapies Treatment Outcome Economic evaluation Physical therapy Health Resources Female Quality-Adjusted Life Years Manual therapy business New Zealand |
| Zdroj: | Osteoarthritis and Cartilage. 21:1504-1513 |
| ISSN: | 1063-4584 |
| DOI: | 10.1016/j.joca.2013.06.014 |
| Popis: | SummaryObjectiveTo evaluate the cost effectiveness of manual physiotherapy, exercise physiotherapy, and a combination of these therapies for patients with osteoarthritis of the hip or knee.Methods206 Adults who met the American College of Rheumatology criteria for hip or knee osteoarthritis were included in an economic evaluation from the perspectives of the New Zealand health system and society alongside a randomized controlled trial. Resource use was collected using the Osteoarthritis Costs and Consequences Questionnaire. Quality-adjusted life years (QALYs) were calculated using the Short Form 6D. Willingness-to-pay threshold values were based on one to three times New Zealand's gross domestic product (GDP) per capita of NZ$ 29,149 (in 2009).ResultsAll three treatment programmes resulted in incremental QALY gains relative to usual care. From the perspective of the New Zealand health system, exercise therapy was the only treatment to result in an incremental cost utility ratio under one time GDP per capita at NZ$ 26,400 (−$34,081 to $103,899). From the societal perspective manual therapy was cost saving relative to usual care for most scenarios studied. Exercise therapy resulted in incremental cost utility ratios regarded as cost effective but was not cost saving. For most scenarios combined therapy was not as cost effective as the two therapies alone.ConclusionsIn this study, exercise therapy and manual therapy were more cost effective than usual care at policy relevant values of willingness-to-pay from both the perspective of the health system and society.Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12608000130369. |
| Databáze: | OpenAIRE |
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