Health-Economic Evaluation of the German Osteoporotic Fracture Prevention Program in Rural Areas (OFRA): Mobility and Falls Prevention Classes, Examination of Bone Health, and Consultation on Safety in the Living Environment

• DOI: 10.1007/s11606-022-07691-2
• Publication Date: 2022-07-25T17:04:05Z
• Authors: Claudia Konnopka; Gisela Büchele; Dietrich Rothenba...; Patrick Roigk; Kilian Rapp; Hans-Helmut König
• Keywords: Male; Frailty; Prevention; Net-benefit approach; Cost-Benefit Analysis; Medical and Health Sciences; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Bone Density; Humans; Cost-effectiveness; Female; Fragility fractures; Referral and Consultation; Osteoporotic Fractures; info:eu-repo/classification/ddc/610; Original Research; Aged

Abstract Background Fragility fractures are one of the leading causes disability in older adults. Yet, evidence for effectiveness and cost-effectiveness preventive approaches combining bone health fall prevention is rare. Objective To conduct a health-economic evaluation German osteoporotic fracture program rural areas (OFRA). Design Secondary cluster–randomized intervention study based on routine data. Participants All districts five federal states Germany were cluster-randomized as or control districts. OFRA was offered to community-living (a) women aged 75–79 years (b) men 70–84 with prior fragility Individuals who meet these criteria assigned group. Intervention comprised mobility falls classes, examination by density measurement, consultation safety home living environment. Main Measures We measured health-care costs terms time death within 1 year after initial contact, insurance claims Implementation recorded performers. calculated an incremental ratio (ICER) employed net-benefit approach construct acceptability curve (CEAC). Key Results There 9408 individuals group 27,318 Mean (difference: 0.82 days) 111.73€, p < .01) reduced, but mean 260.10€) increased total 148.37€, .001) The ICER per fracture-free survival 66,094.63€. CEAC showed no acceptable probability at reasonable willingness pay. Conclusion reduced rates fractures, had high implementation costs, resulting unfavorable ICER. may improve longer follow-up.