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<i>Summary</i> <p>This study evaluated the cost-effectiveness of a care coordination program for hip fracture patients in Korea. The results show the program improves outcomes at a reasonable cost. These findings provide strong evidence to support national adoption of preventive care models for aging populations.</p> Background <p>Femur fractures in elderly patients are associated with high mortality rates and significant healthcare costs. Fracture Liaison Services (FLS) have emerged as a systematic approach to prevent secondary fractures, but their economic evaluation in the Korean healthcare context remains limited.</p> Objective <p>This study aimed to evaluate the cost-utility of implementing FLS coordinator services for patients with femur fractures in Korea.</p> Methods <p>A Markov model-based cost-utility analysis was conducted using National Health Insurance Service claims data (2013–2021) and patient survey data from Eulji University Hospital. The target population included patients aged 50&#xa0;years and older with femur fractures. The analysis adopted a Limited societal perspective with a Lifetime horizon, 6-month cycle length, meaning that both direct medical costs and selected non-medical costs (e.g., caregiver and transportation expenses) were considered over the patients’ remaining Lifetime, with health states updated every 6&#xa0;months in the model. A 4.5% annual discount rate was applied to both costs and quality-adjusted life years (QALYs).</p> Results <p>The incremental cost-effectiveness ratio (ICER) of FLS implementation was 12,057,427 KRW per QALY gained, which is below Korea’s willingness-to-pay threshold of 40 million KRW per QALY. Probabilistic sensitivity analysis showed a 92.2% probability of cost-effectiveness at the 40 million KRW threshold. The FLS program demonstrated a 41% reduction in refracture risk and a 20% reduction in mortality risk.</p> Conclusions <p>FLS coordinator services for femur fracture patients are cost-effective in the Korean healthcare system and should be considered for implementation to improve patient outcomes while managing healthcare expenditures efficiently.</p>

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Cost-utility analysis of coordinator services (FLS) in patients with femur fractures

  • 期刊论文

  • 发表日期：

    2025年10月8日

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  • Gyeong-Min Lee,
  • Han-Sol Jang,
  • Minsu Choi,
  • Yonghan Cha,
  • Seung Hoon Kim,
  • Minah Park,
  • Kwang-Soo Lee,
  • Jae-Hyun Kim

摘要

Summary

This study evaluated the cost-effectiveness of a care coordination program for hip fracture patients in Korea. The results show the program improves outcomes at a reasonable cost. These findings provide strong evidence to support national adoption of preventive care models for aging populations.

Background

Femur fractures in elderly patients are associated with high mortality rates and significant healthcare costs. Fracture Liaison Services (FLS) have emerged as a systematic approach to prevent secondary fractures, but their economic evaluation in the Korean healthcare context remains limited.

Objective

This study aimed to evaluate the cost-utility of implementing FLS coordinator services for patients with femur fractures in Korea.

Methods

A Markov model-based cost-utility analysis was conducted using National Health Insurance Service claims data (2013–2021) and patient survey data from Eulji University Hospital. The target population included patients aged 50 years and older with femur fractures. The analysis adopted a Limited societal perspective with a Lifetime horizon, 6-month cycle length, meaning that both direct medical costs and selected non-medical costs (e.g., caregiver and transportation expenses) were considered over the patients’ remaining Lifetime, with health states updated every 6 months in the model. A 4.5% annual discount rate was applied to both costs and quality-adjusted life years (QALYs).

Results

The incremental cost-effectiveness ratio (ICER) of FLS implementation was 12,057,427 KRW per QALY gained, which is below Korea’s willingness-to-pay threshold of 40 million KRW per QALY. Probabilistic sensitivity analysis showed a 92.2% probability of cost-effectiveness at the 40 million KRW threshold. The FLS program demonstrated a 41% reduction in refracture risk and a 20% reduction in mortality risk.

Conclusions

FLS coordinator services for femur fracture patients are cost-effective in the Korean healthcare system and should be considered for implementation to improve patient outcomes while managing healthcare expenditures efficiently.