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dc.contributor.authorInderjeeth, C.A.
dc.contributor.authorRaymond, W.D.
dc.contributor.authorGeelhoed, E.
dc.contributor.authorBriggs, Andrew
dc.contributor.authorOldham, D.
dc.contributor.authorMountain, D.
dc.date.accessioned2023-09-14T05:48:39Z
dc.date.available2023-09-14T05:48:39Z
dc.date.issued2022
dc.identifier.citationInderjeeth, C.A. and Raymond, W.D. and Geelhoed, E. and Briggs, A. and Oldham, D. and Mountain, D. 2022. Fracture liaison service utilising an emergency department information system to identify patients effectively reduce re-fracture rate is cost-effective and cost saving in Western Australia. Australasian Journal on Ageing. 41 (3): pp. E266-E275.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/93331
dc.identifier.doi10.1111/ajag.13107
dc.description.abstract

Objectives: To assess the benefits of the Emergency Department Information System (EDIS)-linked fracture liaison service (FLS). Methods: Patients identified through EDIS were invited to attend an FLS at the intervention hospital, the Sir Charles Gairdner Hospital (SCGS-FLS). The intervention group was compared to usual care. Retrospective control (RC) at this hospital determined historical fracture risk (SCGH-RC). Prospective control (PC) was from a comparator, Fremantle Hospital (FH-PC). The main outcome measures were cost-effectiveness from a health system perspective and quality of life by EuroQOL (EQ-5D). Bottom-up cost of medical care, against the cost of managing recurrent fracture (weighted basket), was determined from the literature and 2013/14 Australian Refined Diagnosis Related Groups (AR-DRG) prices. Mean incremental cost-effectiveness ratios were simulated from 5000 bootstrap iterations. Cost-effectiveness acceptability curves were generated. Results: The SCGH-FLS program reduced absolute re-fracture rates versus control cohorts (9.2–10.2%), producing an estimated cost saving of AUD$750,168–AUD$810,400 per 1000 patient-years in the first year. Between-groups QALYs differed with worse outcomes in both control groups (p < 0.001). The SCGH-FLS compared with SCGH-RC and FH-PC had a mean incremental cost of $8721 (95% CI −$1218, $35,044) and $8974 (95% CI −$26,701, $69,929), respectively, per 1% reduction in 12-month recurrent fracture risk. The SCGH-FLS compared with SCGH-RC and FH-PC had a mean incremental cost of $292 (95% CI −$3588, $3380) and −$261 (95% CI −$1521, $471) per EQ-5D QALY gained at 12 months respectively. With societal willingness to pay of $16,000, recurrent fracture is reduced by 1% in >80% of patients. Conclusions: This simple and easy model of identification and intervention demonstrated efficacy in reducing rates of recurrent fracture and was cost-effective and potentially cost saving.

dc.languageEnglish
dc.publisherWILEY
dc.relation.sponsoredbyhttp://purl.org/au-research/grants/nhmrc/1132548
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectGeriatrics & Gerontology
dc.subjectGerontology
dc.subjectanalyses
dc.subjectcost benefit
dc.subjectfractures
dc.subjecthealth care economics and organizations
dc.subjectintegrated health care systems
dc.subjectosteoporotic
dc.subjectprevention
dc.subjectsecondary
dc.subjectOSTEOPOROTIC FRACTURE
dc.subjectTRAUMA FRACTURE
dc.subjectMANAGEMENT
dc.subjectCARE
dc.subjectINTERVENTION
dc.subjectPREVALENCE
dc.subjectIMPROVE
dc.subjectRISK
dc.subjectMEN
dc.subjectanalyses
dc.subjectcost benefit
dc.subjectfractures
dc.subjecthealth care economics and organizations
dc.subjectintegrated health care systems
dc.subjectosteoporotic
dc.subjectprevention
dc.subjectsecondary
dc.subjectAustralia
dc.subjectCost Savings
dc.subjectCost-Benefit Analysis
dc.subjectEmergency Service, Hospital
dc.subjectHumans
dc.subjectInformation Systems
dc.subjectOsteoporotic Fractures
dc.subjectProspective Studies
dc.subjectQuality of Life
dc.subjectRetrospective Studies
dc.subjectWestern Australia
dc.subjectHumans
dc.subjectRetrospective Studies
dc.subjectProspective Studies
dc.subjectQuality of Life
dc.subjectInformation Systems
dc.subjectEmergency Service, Hospital
dc.subjectCost-Benefit Analysis
dc.subjectCost Savings
dc.subjectAustralia
dc.subjectWestern Australia
dc.subjectOsteoporotic Fractures
dc.titleFracture liaison service utilising an emergency department information system to identify patients effectively reduce re-fracture rate is cost-effective and cost saving in Western Australia
dc.typeJournal Article
dcterms.source.volume41
dcterms.source.number3
dcterms.source.startPageE266
dcterms.source.endPageE275
dcterms.source.issn1440-6381
dcterms.source.titleAustralasian Journal on Ageing
dc.date.updated2023-09-14T05:48:38Z
curtin.departmentCurtin School of Allied Health
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidBriggs, Andrew [0000-0002-6736-3098]
dcterms.source.eissn1741-6612
curtin.contributor.scopusauthoridBriggs, Andrew [7102129692]
curtin.repositoryagreementV3


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