Cost-Utility Analysis of Osteoporotic Hip Fractures in Thais
Wiwat Wajanavisit MD*, Patarawan Woratanarat MD, PhD*, Sansanee Sawatriawkul BSc, MSc*, Chatchawal Lertbusayanukul MD*, Boonsong Ongphiphadhanakul MD**
Affiliation : * Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
A prospective study was conducted among osteoporotic hip fracture in 2008. It was aimed to assess cost per quality adjusted life year (QALY) of hip fracture in the context of a developing country. The patients who were diagnosed as hip fracture and admitted to the orthopedic wards were included. Any pathological fractures or missing data were discarded from the analysis. Median cost was evaluated from a societal perspective. EQ-5D was used to assess health utility state and then converted into a time trade off. Cost per QALY was estimated at one year of follow-up. Forty-two patients completed a quality of life assessment. The average age was 75.6 years old and 71% were female. Most of them were undergone either hemiarthroplasty or internal fixation. The median total cost per year was US$ 4,210.60. The median QALY was 0.636 and cost per QALY was US$ 6,620.52. Cost utility of a hip fracture in Thai setting was lower than other developed countries due to strong family support and insufficient rehabilitation. However, it has high impact on 78.8% of the Thai Gross National Product. Prevention of hip fracture is needed in underdeveloped countries as much as others, worldwide.
Keywords : Cost, QALY, Utility, Hip fracture, Thai
