Cost-effectiveness of hip protectors in the prevention of osteoporosis related hip fractures in elderly nursing home residents.

Abstract

Hip fracture is a common complication of osteoporosis, resulting in significant morbidity and mortality, with a high financial cost to the healthcare system. Hip protectors have been advocated as an effective method to prevent hip fractures in high-risk individuals. This study models the cost-effectiveness of hip protectors in the prevention of osteoporosis related hip fractures in elderly nursing home residents. An incremental cost-effectiveness analysis was performed comparing hip protectors to "no treatment" and to "calcium and vitamin D supplements." The study population was a hypothetical cohort of 1000 nursing home residents. A societal perspective, with a lifetime time horizon, was adopted. Data regarding costs, effectiveness, and quality of life measures were collected from the current literature and from Peace Arch Hospital, a community hospital in White Rock, British Columbia, Canada. Sensitivity analysis was performed. Hip protector use was found to be a dominant strategy compared to no treatment and to calcium and vitamin D supplements. Dominance implies lower cost and higher effect, generating cost-effectiveness ratios less than zero. Dominance with respect to cost and effectiveness of hip protectors in preventing hip fractures persisted when the model was subjected to probabilistic sensitivity analysis. Cost-effectiveness analysis suggests that hip protectors could save money while preventing hip fractures and improving quality of life in nursing home residents.