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An outreach rehabilitation program for nursing home residents after hip fracture may be cost-saving

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dc.contributor.author Beaupre, Lauren A.
dc.contributor.author Lier, Doug
dc.contributor.author Magaziner, Jay S.
dc.contributor.author Jones, Allyson C.
dc.contributor.author Johnston, William C.
dc.contributor.author Wilson, Donna M.
dc.contributor.author Majumdar, Sumit R.
dc.date.accessioned 2020-05-14T11:07:30Z
dc.date.issued 2020
dc.identifier.uri http://hdl.handle.net.proxy.lib.ul.ie/10344/8814
dc.description peer-reviewed en_US
dc.description.abstract Background We compared the cost-effectiveness of 10 weeks of outreach rehabilitation (intervention) versus usual care (control) for ambulatory nursing home residents after hip fracture. Methods Enrollment occurred February 2011 through June 2015 in a Canadian metropolitan region. Seventy-seven participants were allocated in a 2:1 ratio to receive a 10-week rehabilitation program (intervention) or usual care (control) (46 intervention; 31 control). Using a payer perspective, we performed main and sensitivity analyses. Health outcome was measured by quality-adjusted life years (QALYs), using the EQ5D, completed at study entry, 3-, 6-, and 12-months. We obtained patient-specific data for outpatient visits, physician claims, and inpatient readmissions; the trial provided rehabilitation utilization/cost data. We estimated incremental cost and incremental effectiveness. Results Groups were similar at study entry; the mean age was 87.9 ± 6.6 years, 54 (71%) were female and 58 (75%) had severe cognitive impairment. EQ5D QALYs scores were nonsignificantly higher for intervention participants. Inpatient readmissions were two times higher among controls, with a cost difference of −$3,350/patient for intervention participants, offsetting the cost/intervention participant of $2,300 for the outreach rehabilitation. The adjusted incremental QALYs/patient difference was 0.024 favoring the intervention, with an incremental cost/patient of −$621 for intervention participants; these values were not statistically significant. A sensitivity analysis reinforced these findings, suggesting that the intervention was likely dominant. Conclusion A 10-week outreach rehabilitation intervention for nursing home residents who sustain a hip fracture may be cost-saving, through reduced postfracture hospital readmissions. These results support further work to evaluate postfracture rehabilitation for nursing home residents. en_US
dc.language.iso eng en_US
dc.publisher Oxford University Press en_US
dc.relation.ispartofseries The Journal of Gerontology: Series a; 75 (10), e159-e165
dc.rights This is a pre-copyedited, author-produced PDF of an article accepted for publication in The Journal of Gerontology: series a following peer review. The version of record is available online at: https://doi-org.proxy.lib.ul.ie/10.1093/gerona/glaa074 en_US
dc.subject cost-effectiveness en_US
dc.subject functional recovery en_US
dc.subject hip fracture en_US
dc.subject nursing home en_US
dc.subject rehabilitation en_US
dc.title An outreach rehabilitation program for nursing home residents after hip fracture may be cost-saving en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.date.embargoEndDate 2021-03-26
dc.embargo.terms 2021-03-26 en_US
dc.rights.accessrights info:eu-repo/semantics/embargoedAccess en_US


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