PMID- 25572047
OWN - NLM
STAT- MEDLINE
DCOM- 20160218
LR  - 20181113
IS  - 1433-2965 (Electronic)
IS  - 0937-941X (Linking)
VI  - 26
IP  - 4
DP  - 2015 Apr
TI  - Cost-effectiveness of hip protector use on a geriatric ward in Germany: a Markov 
      model.
PG  - 1367-79
LID - 10.1007/s00198-014-3008-7 [doi]
AB  - In this study, we determined the cost-effectiveness of hip protector use compared 
      with no hip protector on a geriatric ward in Germany. From both the societal and 
      the statutory health insurance (SHI) perspectives, the cost-effectiveness ratios 
      for the provision of hip protectors were below <euro>12,000/quality-adjusted life 
      year (QALY) even if unrelated costs in added life years were included. 
      INTRODUCTION: The aim of this study is to determine the cost-effectiveness of the 
      provision of hip protectors compared with no hip protectors on a geriatric ward 
      in Germany. METHODS: A lifetime decision-analytic Markov model was developed. 
      Costs were measured from the societal and from the statutory health insurance 
      (SHI) perspectives and comprised direct medical, non-medical and unrelated costs 
      in additional life years gained. Health outcomes were measured in terms of 
      quality-adjusted life years (QALYs). To reflect several levels of uncertainty, 
      first- and second-order Monte Carlo simulation (MCS) approaches were applied. 
      RESULTS: Hip protector use compared with no hip protector results in savings 
      (costs, -5.1/QALYs, 0.003) for the societal perspective. For the SHI perspective, 
      the incremental cost-effectiveness ratio was <euro>4416 <euro>/QALY (costs, 
      +13.4). If unrelated costs in life years gained were included, the 
      cost-effectiveness ratio increases to <euro>9794/QALY for the societal 
      perspective and to <euro>11,426/QALY for the SHI perspective. In the MCS, for the 
      societal perspective without unrelated costs, 47 % of simulations indicated hip 
      protectors to be cost saving (i.e. lower costs and higher effects). CONCLUSION: 
      Although the gain in QALYs due to the provision of providing hip protectors to 
      patients on geriatric wards is small, all scenarios showed acceptable 
      cost-effectiveness ratios or even savings.
FAU - Stollenwerk, B
AU  - Stollenwerk B
AD  - Helmholtz Zentrum Munchen, German Research Center for Environmental Health, 
      Institute of Health Economics and Health Care Management, Ingolstadter Landstrasse 
      1, 85764, Neuherberg, Germany, bjoern.stollenwerk@helmholtz-muenchen.de.
FAU - Bartmus, T
AU  - Bartmus T
FAU - Klug, F
AU  - Klug F
FAU - Stock, S
AU  - Stock S
FAU - Muller, D
AU  - Muller D
LA  - eng
PT  - Journal Article
DEP - 20150109
PL  - England
TA  - Osteoporos Int
JT  - Osteoporosis international : a journal established as result of cooperation 
      between the European Foundation for Osteoporosis and the National Osteoporosis 
      Foundation of the USA
JID - 9100105
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cost-Benefit Analysis
MH  - Decision Support Techniques
MH  - Female
MH  - Germany
MH  - Health Care Costs/*statistics & numerical data
MH  - Health Services Research/methods
MH  - Hip Fractures/*economics/*prevention & control
MH  - Humans
MH  - Male
MH  - Markov Chains
MH  - *Models, Econometric
MH  - Patients' Rooms/*economics
MH  - Protective Devices/*economics
MH  - Quality-Adjusted Life Years
MH  - Sensitivity and Specificity
EDAT- 2015/01/13 06:00
MHDA- 2016/02/19 06:00
CRDT- 2015/01/10 06:00
PHST- 2014/06/16 00:00 [received]
PHST- 2014/12/15 00:00 [accepted]
PHST- 2015/01/10 06:00 [entrez]
PHST- 2015/01/13 06:00 [pubmed]
PHST- 2016/02/19 06:00 [medline]
AID - 10.1007/s00198-014-3008-7 [doi]
PST - ppublish
SO  - Osteoporos Int. 2015 Apr;26(4):1367-79. doi: 10.1007/s00198-014-3008-7. Epub 2015 
      Jan 9.