Nonoperative versus operative management of frail institutionalized older patients with a proximal femoral fracture: a cost-utility analysis alongside a multicenter prospective cohort study
Errata to this article were published (Osteoporos Int, Mar 2023 ↗ · Sep 2025 ↗)
Main finding · Healthcare costsResult — go to the resultICER per QALY gained €76,912Authors' conclusion
OM results in significant higher healthcare costs, mainly due to the length of hospital stay.
Study context
- Population
- Institutionalized patients with a limited life expectancy aged ≥ 70 years with a proximal femoral fracture, the Netherlands
- Participants
- 172 patients
- Exposure
- Nonoperative management vs operative management
- Nonoperative management (NOM)n = 88
- Operative management (OM)n = 84reference
- Outcome
- Healthcare costs and cost-utility (ICER per QALY, EuroQol-5D-5L)
- Follow-up
- 6 months
Methodological detailsmulticenter, societal perspective
- Multicenter
- Societal perspective
Main finding
Healthcare costs
Incremental cost-effectiveness ratio (ICER) per quality adjusted life years (QALY) gained
€76,912
By group
NOM
€2425
SD 1.030
OM
€9325
SD 4242
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | NOM | OM |
|---|---|---|
| Hospital stay costs (main cost driver) | €738 (SD 841) | €3140 (SD 2636) |
Patients who died within 14- and 30-day post-injury
- Minimal QALY gained with OM, but more than triple the costs
Original publication
Nonoperative versus operative management of frail institutionalized older patients with a proximal femoral fracture: a cost-utility analysis alongside a multicenter prospective cohort study. Osteoporos Int. Published 7 January 2023. doi:10.
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