Table 1.
Model parameters
| Parameter | Mean (95%CI) | Source |
|---|---|---|
| Relative effectiveness (hazard ratio) | ||
| Introducing OG relative to usual care | ||
| 30-day mortality following index hip fracture | 0.73 (0.65-0.82) | (15) |
| 1-year mortality following index hip fracture | 0.81 (0.75-0.87) | (15) |
| 2-year risk of developing second hip fracture | 0.95 (0.79-1.15) | (15) |
| Introducing FLS relative to usual care | ||
| 30-day mortality following index hip fracture | 0.80 (0.71-0.91) | (15) |
| 1-year mortality following index hip fracture | 0.84 (0.77-0.93) | (15) |
| 2-year risk of developing second hip fracture | 1.03 (0.85-1.26) | (15) |
| Discharge to care home after index hip fracture (previously not in care home) | Supplementary Table 8 | HES |
| Discharge to care home after second hip fracture (previously not in care home) | Supplementary Table 8 | HES |
| Risk of second hip fracture | Supplementary Table 9 | HES |
| Risk of major non-hip fracture requiring hospitalisation | Supplementary Table 9 | HES |
| 30-day mortality after index hip fracture | Supplementary Table 9 | HES |
| 30-day mortality after 2nd hip fracture | Supplementary Table 9 | HES |
| All-cause mortality post 30 days of fracture | Supplementary Table 9 | HES |
| Intervention cost* | ||
| Fracture liaison nurse (Grade 7) per hip fracture patient | £200 | (18) |
| Orthogeriatrician (Consultant) | £420 | (18) |
| Proportion discharged to a care home that go to a nursing home | 0.48 (0.47-0.49) | (20) |
| Primary care costs in year of index fracture | Supplementary Table 10 | CPRD |
| Primary care costs in years after index fracture | Supplementary Table 10 | CPRD |
| Hospitalisation costs in year of index hip fracture | Supplementary Table 11 | HES |
| Hospitalisation costs in year of 2nd hip fracture | Supplementary Table 11 | HES |
| Hospitalisation costs in years following fracture | Supplementary Table 11 | HES |
| Hospitalisation costs if non-hip fracture occurs | Supplementary Table 12 | HES |
| Hospitalisation costs if death occurs | Supplementary Table 12 | HES |
| Cost of institutionalisation (per year)** | ||
| Nursing home | £39,000 | (18) |
| Residential home | £27,664 | (18) |
| Utility of hip fracture patients | ||
| Within 1 month of index fracture | 0.46 (0.38-0.55) | Lit review |
| At 12 months | 0.53 (0.47-0.61) | Lit review |
| At 24 months and after | 0.66 (0.60-0.74) | Lit review |
| Discount rate for costs and outcomes | 3.5% | HM Treasury |
*
includes salary, salary oncosts, qualification costs, management and non-staff overheads and capital overheads
**
Nursing home at £39,000 per year (£750 per week times 52 weeks) and residential home at £27,664 per year (£532 per week times 52 weeks); HES: Hospital Episode Statistics database; CPRD: Clinical Practice Research Datalink database