Hemiarthroplasty vs. internal fixation for nondisplaced femoral neck fracture in mainland China: a cost-effectiveness analysis
Year: 2024
Type: article
Abstract: Objective: Nondisplaced femoral neck fractures constitute a substantial portion of these injuries. The optimal treatment strategy between internal fixation (IF) and hemiarthroplasty (HA) remains debated, particularly concerning cost-effectiveness. Methods: We conducted a cost-effectiveness analysis using a Markov decision model to compare HA and IF in treating nondisplaced femoral neck fractures in elderly patients in China. The analysis was performed from a payer perspective with a 5-year time horizon. Costs were measured in 2020 USD, and effectiveness was measured in quality-adjusted life-years (QALYs). Sensitivity analyses, including one-way and probabilistic analyses, were conducted to assess the robustness of the results. The willingness-to-pay threshold for incremental cost-effectiveness ratio (ICER) was set at $11,083/QALY following the Chinese gross domestic product in 2020. Results: HA demonstrated higher cumulative QALYs (2.94) compared to IF (2.75) but at a higher total cost ($13,324 vs. $12,167), resulting in an ICER of $6,128.52/QALY. The one-way sensitivity analysis identified the costs of HA and IF as the most influential factors. Probabilistic sensitivity analysis indicated that HA was more effective in 69.3% of simulations, with an ICER below the willingness-to-pay threshold of $11,083 in 58.8% of simulations. Conclusions: HA is a cost-effective alternative to IF for treating nondisplaced femoral neck fractures in elderly patients in mainland China.
Source: Frontiers in Surgery
Authors: Shengchun Wang, Lingjie Tan, Bin Sheng
Institutions: Hunan Normal University, Hunan Provincial People's Hospital
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,295
OpenAlex ID: W4401996182