Abstract
SummaryHip fracture patients can benefit from nutritional supplementation during their recovery. Up to now, cost-effectiveness evaluation of nutritional intervention in these patients has not been performed. Costs of nutritional intervention are relatively low as compared with medical costs. Cost-effectiveness evaluation shows that nutritional intervention is likely to be cost-effective.IntroductionPrevious research on the effect of nutritional intervention on clinical outcome in hip fracture patients yielded contradictory results. Cost-effectiveness of nutritional intervention in these patients remains unknown. The aim of this study was to evaluate cost-effectiveness of nutritional intervention in elderly subjects after hip fracture from a societal perspective.MethodsOpen-label, multi-centre randomized controlled trial investigating cost-effectiveness of intensive nutritional intervention comprising regular dietetic counseling and oral nutritional supplementation for 3 months postoperatively. Patients allocated to the control group received care as usual. Costs, weight and quality of life were measured at baseline and at 3 and 6 months postoperatively. Incremental cost-effectiveness ratios (ICERs) were calculated for weight at 3 months and quality adjusted life years (QALYs) at 6 months postoperatively.ResultsOf 152 patients enrolled, 73 were randomized to the intervention group and 79 to the control group. Mean costs of the nutritional intervention was 613 Euro. Total costs and subcategories of costs were not significantly different between both groups. Based on bootstrapping of ICERs, the nutritional intervention was likely to be cost-effective for weight as outcome over the 3-month intervention period, regardless of nutritional status at baseline. With QALYs as outcome, the probability for the nutritional intervention being cost-effective was relatively low, except in subjects aged below 75 years.ConclusionIntensive nutritional intervention in elderly hip fracture patients is likely to be cost-effective for weight but not for QALYs. Future cost-effectiveness studies should incorporate outcome measures appropriate for elderly patients, such as functional limitations and other relevant outcome parameters for elderly.
Highlights
In The Netherlands, as well as in other countries, the incidence of hip fractures in the elderly is high, and it is expected to increase in the nearby future
Both hip fracture patients and malnourished patients in general have an increased use of health care as compared with wellnourished and non-fracture patients, and it is expected that it would result in higher health care costs [18,19,20,21]
The estimated intervention effect from baseline to 3 months postoperatively was 1.91 kg
Summary
In The Netherlands, as well as in other countries, the incidence of hip fractures in the elderly is high, and it is expected to increase in the nearby future. Malnutrition in hip fracture patients is reported to be associated with impaired muscle function, disability, loss of independency, decreased quality of life, delayed wound healing, higher complication rate, prolonged rehabilitation time, and increased mortality rate [7, 8, 10,11,12,13,14,15,16,17] Both hip fracture patients and malnourished patients in general have an increased use of health care as compared with wellnourished and non-fracture patients, and it is expected that it would result in higher health care costs [18,19,20,21]. Treatment of malnutrition is of vital importance to minimize losses and to achieve rapid weight recovery after hip fracture
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
