Article

OBJECTIVE: To evaluate costs and cost-effectiveness of physical and geriatric
rehabilitation after hip fracture. DESIGN: Prospective randomised study (mean age
78 years, 105 male, 433 female) in different rehabilitation settings : physically
oriented (187 patients), geriatrically oriented (171 patients), and healthcare
centre hospital (control, 180 patients). MAIN MEASURES:
At 12 months
post-fracture, we collected data regarding days in rehabilitation,
post-rehabilitation hospital treatment, other healthcare service use, number of
re-operations, taxi use by patient or relative, and help from relatives. RESULTS:
Control rehabilitation (4945,2euro) was significantly less expensive than
physical (6609.0euro, p=0.002) and geriatric rehabilitation (7034.7euro p<0.001).
Total institutional care costs (primary treatment, rehabilitation, and
post-rehabilitation hospital care) were lower for control (13,438.4euro) than
geriatric rehabilitation (17,201.7euro, p<0.001), but did not differ between
control and physical rehabilitation (15659.1euro, p=0.055) or between physical
and geriatric rehabilitation ( p=0.252). Costs of help from relatives (estimated
as 30%, 50% and 100% of a home aid's salary) with physical rehabilitation were
lower than control ( p=0.016) but higher than geriatric rehabilitation (
p=0.041). Total hip fracture treatment costs were lower with physical
(36,356euro, 51,018euro) than control rehabilitation (38,018euro, 57,031euro) at
50% and 100% of salary ( p=0.032, p=0.014, respectively).
At one year
post-fracture, 15D-score was significantly higher in physical rehabilitation
group (0.697) than geriatric rehabilitation group (0.586, p=0.008) and control
group (0.594, p=0.009). CONCLUSIONS: Considering total costs one year after hip
fracture the treatment including physical rehabilitation is significantly more
cost-effective than routine treatment. This effect could not be seen between
routine treatment and treatment including geriatric rehabilitation.

Langue : ANGLAIS