Cost-effectiveness of hip protectors in the prevention of osteoporosis related hip fractures in elderly nursing home residents.

OBJECTIVE Hip fracture is a common complication of osteoporosis, resulting in significant morbidity and mortality, with a high financial cost to the healthcare system. Hip protectors have been advocated as an effective method to prevent hip fractures in high-risk individuals. This study models the cost-effectiveness of hip protectors in the prevention of osteoporosis related hip fractures in elderly nursing home residents. METHODS An incremental cost-effectiveness analysis was performed comparing hip protectors to "no treatment" and to "calcium and vitamin D supplements." The study population was a hypothetical cohort of 1000 nursing home residents. A societal perspective, with a lifetime time horizon, was adopted. Data regarding costs, effectiveness, and quality of life measures were collected from the current literature and from Peace Arch Hospital, a community hospital in White Rock, British Columbia, Canada. Sensitivity analysis was performed. RESULTS Hip protector use was found to be a dominant strategy compared to no treatment and to calcium and vitamin D supplements. Dominance implies lower cost and higher effect, generating cost-effectiveness ratios less than zero. Dominance with respect to cost and effectiveness of hip protectors in preventing hip fractures persisted when the model was subjected to probabilistic sensitivity analysis. CONCLUSION Cost-effectiveness analysis suggests that hip protectors could save money while preventing hip fractures and improving quality of life in nursing home residents.