"Eesti Teadusfondi uurimistoetus" projekt ETF9368
ETF9368 "Osteoporootilise luumurruga seostud kulude ja elukvaliteedi uuring (1.01.2012−31.12.2015)", Anneli Uusküla, Tartu Ülikool, Arstiteaduskond.
ETF9368
Osteoporootilise luumurruga seostud kulude ja elukvaliteedi uuring
COSTS AND UTILITIES RELATED TO OSTEOPOROTIC FRACTURES: ESTONIAN AND INTERNATIONAL COMPARISONS
1.01.2012
31.12.2015
Teadus- ja arendusprojekt
Eesti Teadusfondi uurimistoetus
ValdkondAlamvaldkondCERCS erialaFrascati Manual’i erialaProtsent
3. Terviseuuringud3.7. Kliiniline meditsiinB580 Skeleti ja lihassüsteemi haigused, reumatoloogilised haigused3.2. Kliiniline meditsiin (anestesioloogia, pediaatria, sünnitusabi ja günekoloogia, sisehaigused, kirurgia, stomatoloogia, neuroloogia, psühhiaatria, radioloogia, terapeutika, otorinolarüngoloogia, oftalmoloogia)100,0
AsutusRollPeriood
Tartu Ülikool, Arstiteaduskondkoordinaator01.01.2012−31.12.2015
PerioodSumma
01.01.2012−31.12.201215 000,00 EUR
01.01.2013−31.12.201315 000,00 EUR
01.01.2014−31.12.201415 000,00 EUR
01.01.2015−31.12.201515 000,00 EUR
60 000,00 EUR

Osteoporotic (OP) fractures are an important public health problem due to increased mortality and reduced quality of life as well as the incremental societal costs. The risk of OP fractures can be reduced by applying different preventive and treatment measures, such as a change in health behavior or the use of drugs. For assessing cost-effectiveness of health care measures, reliable local data on morbidity, quality of life and costs related to OP- fractures are required. Quality of life (QoL) is an important clinical outcome measure. Costs related to OP can be divided into direct medical and non-medical, non-formal and indirect costs. Objective of the study: To assess the total cost, cost structure and changes in health-related quality of life related to OP hip fractures, and to establish a knowledge base for assessment of cost-utility of health care measures related to OP in Estonia. Methods: We will conduct a prospective study where 200 patients with an OP hip fracture will be followed up for 18 months post fracture. Follow-up data will be collected at four time points: baseline and at 3 follow up visits (4, 12 and 18 months after fraction). Data sources: (i) patients (health, QoL - EQ-5D, time trade-off question, non medical/formal, indirect costs), (ii) clinical data (data abstraction from clinical data); (iii) Estonian Health Insurance Fund (data on health care services and prescribed medication utilisation – direct medical costs). We will use a convenience sample by recruiting patients from the department of Traumatology and Orthopaedics of the University of Tartu. Informed consent for participation and 18 months follow-up procedures will be secured from all study participants. The present study is a part of an ongoing international study The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) (http://www.medscinet.com/icuros/project.aspx). The study will be undertaken by a multi disciplinary team of researchers at the Medical Faculty of the University of Tartu in cooperation with the ICUROS team (incl the Health Economic Group). The study provides an opportunity for (i) systematic cost-utility assessment of preventive and treatment measures related to OP fractures; (ii) provides input for informed health policy decisions in an environment with limited health care resources; and (iii) contribution to capacity development for health research in Estonia.
Osteoporotic (OP) fractures are an important public health problem due to increased mortality and reduced quality of life as well as the incremental societal costs. The risk of OP fractures can be reduced by applying different preventive and treatment measures, such as a change in health behavior or the use of drugs. For assessing cost-effectiveness of health care measures, reliable local data on morbidity, quality of life and costs related to OP- fractures are required. Quality of life (QoL) is an important clinical outcome measure. Costs related to OP can be divided into direct medical and non-medical, non-formal and indirect costs. Objective of the study: To assess the total cost, cost structure and changes in health-related quality of life related to OP hip fractures, and to establish a knowledge base for assessment of cost-utility of health care measures related to OP in Estonia. Methods: We will conduct a prospective study where 200 patients with an OP hip fracture will be followed up for 18 months post fracture. Follow-up data will be collected at four time points: baseline and at 3 follow up visits (4, 12 and 18 months after fraction). Data sources: (i) patients (health, QoL - EQ-5D, time trade-off question, non medical/formal, indirect costs), (ii) clinical data (data abstraction from clinical data); (iii) Estonian Health Insurance Fund (data on health care services and prescribed medication utilisation – direct medical costs). We will use a convenience sample by recruiting patients from the department of Traumatology and Orthopaedics of the University of Tartu. Informed consent for participation and 18 months follow-up procedures will be secured from all study participants. The present study is a part of an ongoing international study The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) (http://www.medscinet.com/icuros/project.aspx). The study will be undertaken by a multi disciplinary team of researchers at the Medical Faculty of the University of Tartu in cooperation with the ICUROS team (incl the Health Economic Group). The study provides an opportunity for (i) systematic cost-utility assessment of preventive and treatment measures related to OP fractures; (ii) provides input for informed health policy decisions in an environment with limited health care resources; and (iii) contribution to capacity development for health research in Estonia.
The project aim as to assess the impact of hip fracture on health-related quality of life (HRQoL) and costs in Estonia. To fulfill this aim we conducted a cohort study of 205 hip fracture patients ≥50 years. The study subjects were followed up for 18 months (post fracture). HRQoL was estimated before fracture (recall), after fracture, and at 4, 12, and 18 months using the EQ-5D instrument. Health care utilization and costs were obtained from a public health insurance fund database; social, informal, and indirect costs were estimated using patient-reported data. RESULTS: Hip fracture resulted in the mean 18-month HRQoL loss of 0.31 QALYs. The mean 18-months cumulative cost of hip fracture from a societal perspective was estimated at 8146 (95 % CI 6236-10717) euros per patient. Most of the cost was related to health care (56 %) and informal care (33 %), while social care contributed only 5 %. Utilization of outpatient rehabilitation and nursing care was low (8 % of patients). CONCLUSIONS: The impact of hip fracture on HRQoL and cost was substantial. Despite appropriate inpatient care, utilization of rehabilitation, nursing care, and social care were low and potentially insufficient to meet the needs of patients with low HRQoL. The shortfall may partially explain a remarkably high use of informal care. Over the 4 years of project we have published 3 international peer reviewed research papers; and we continue with the analysis/publication of the project results. The research presented here is a base for the Mikk Jürisson PhD dissertatsion.