An economic analysis of external hip protector use in ambulatory nursing facility residents

Objective: to evaluate the economic impact of external hip protector use in nursing facilities. Design: cost-effectiveness and cost-utility analyses. Measurements: event probabilities, intervention effectiveness, treatment costs, and utility of hip fracture state were determined from peer-reviewed medical literature and public use data. Methods: a societal perspective with an 18-month time horizon was used. A decision tree model was constructed. Expected cost, effectiveness, and incremental cost-effectiveness ratio were calculated. One and two-way sensitivity analyses and threshold analyses were performed. Results: the strategy of using external hip protectors saves approximately US$300 per subject and adds 0.01 quality adjusted life year over 18 months. The model remains dominant over the entire range of input values for all variables except the cost of hip protectors. At the maximum estimated cost of US$695/subject/18 months, the incremental cost-effectiveness ratio was $30,600/quality adjusted life year. The strategy of using hip protectors was cost saving or cost neutral if the cost of hip protector strategy is less than or equal toUS$397/subject/18 months. Conclusions: using external hip protectors in nursing facilities is cost saving or economically attractive over a wide range of cost and utility assumptions.