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Wiley InterScience | |||||||
  Journal of the American Geriatrics SocietyVolume 53 Issue 2, Pages 190 - 197 Published Online: 26 Jan 2005 Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.
Abstract | References | Full Text: HTML, PDF (Size: 107K) | Related Articles | Citation Tracking  A Cost-Benefit Analysis of External Hip Protectors in the Nursing Home Setting Dr. Honkanen was a Hartford Foundation/AFAR Geriatric Medicine Scholar during this work. Dr. Mushlin is a Nanette Laitman Distinguished Professor of Public Health. Dr. Lachs is a Paul Beeson Physician Faculty Scholar and recipient of Academic Leadership Award K0800580 from the National Institute on Aging. Grant support was received from the Hartford/AFAR Academic Fellowship Program in Geriatric Medicine and Geriatric Psychiatry, 2002. This work was presented at the American Geriatrics Society Annual Meeting in Baltimore, Maryland, May 16, 2003, where it received the Presidential Poster Award in the category of Economics. Copyright © 2005 by the American Geriatrics Society KEYWORDS hip protectors • health economics • nursing home • hip fracture ABSTRACTObjectives: To estimate potential cost savings generated by a program of hip protectors in the nursing home from a Medicare perspective. Design: A state-transition Markov model considering short-term and long-term outcomes of hip protectors for a hypothetical nursing home population, stratified by age, sex, and functional status. Costs, transition probabilities between health states, and estimates of hip protectors' effectiveness were derived from published secondary data. Setting: Nursing home facilities in the United States. Participants: Hypothetical cohort of permanent nursing home residents aged 65 and older without a previous hip fracture. Intervention: Program of hip protectors reimbursed by Medicare. Measurements: Number of fractures, life years, and dollars saved. Results: Three pairs of hip protectors replaced annually would result in a weighted average lifetime absolute risk reduction for hip fracture of 8.5%, with net lifetime savings to Medicare of $223 per resident. When the annual cost of hip protectors is less than $151 per person, relative risk of fracture is less than or equal to 0.65 with hip protectors, or adherence is greater than 42%, hip protectors are cost saving to Medicare over a wide range of assumptions. Extrapolating these results to the estimated population of U.S. nursing home residents without a previous hip fracture, Medicare could save $136 million in the first year of a hip-protector reimbursement program. Conclusion: From a Medicare perspective, hip protectors are a cost-saving intervention in the nursing home setting when hip protector effectiveness is less than or equal to 0.65 over the remaining lifetime of subjects. | 
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